Raj N. Sureja, MD
The use of Spinal Cord Stimulation (SCS) or Neuromodulation has been a life changer for hundreds of thousands of individuals around the world – providing pain relief and a return to a better quality of life when medications, interventional procedures and even surgery may have failed. While there have been innumerable benefits to the use of SCS for patients, there are some limitations that must be considered when considering implantation of these devices. In this article, I will discuss the restrictions to be considered.
MRI Scans – It used to be that all SCS units were incompatible with MR scans because they contained metal. This provided a challenge when patients needed imaging beyond what an x-ray could provide. MR scanners use large magnets powered by electricity to scan water molecules in the body to create images. A large magnet would obviously attract anything metallic in nature and could potentially dislodge, move, or even extract the neuromodulation leads or battery from the body, causing harm or even death. A CT scan would be the only other imaging option for those patients when physicians needed a more detailed view of their anatomy for diagnostic purposes.
Currently, most neuromodulation manufacturers are producing units that are MR scanner compatible – meaning that the components used in the leads and batteries are safe to be used in proximity to the electrified magnet of the MR scanner. This is a giant leap forward in the technology of the SCS units and one that has been eagerly awaited by providers and patients alike. Most patients now are being implanted with the MR scanner compatible SCS devices.
Driving – Although some of the newer, high frequency SCS units are safer to drive with while using, most of the time, it is recommended that you power off your device while driving. Because of the unique positions assumed while driving, extra pressure can be put on the leads and the battery itself, causing the sensations generated to be more startling or intense than normal. While not typically painful, these sensations can be distracting to the driver. If you are planning a long car trip and need to drive, discuss your options with me beforehand on how to best manage your pain. You can also contact your manufacturer’s representative for additional instruction.
Air Travel – Now that many COVID-19 restrictions have been lifted, more Americans are taking to the air. Be aware that your SCS device will show up on a TSA x-ray scanner. You should have an authorization/explanation card to provide to the TSA agent on duty to allow you to quickly pass-through security without a problem. It is perfectly safe to fly with your SCS device on any setting you desire. As with driving, however, remember that your seated position may put extra pressure on your battery and/or leads, so you may have to adjust your settings more often to be comfortable.
Medical Treatment – It is important to let all other treating physicians and dentists know that you have a spinal cord stimulator implanted. You may also want to wear a bracelet or carry your ID card with you at all times in case of a medical emergency.
Other activities – Having less pain means you can enjoy life more fully and I encourage you to do so! Do whatever your heart desires, whether it be mountain biking, gardening, jumping out of a plane or walking on the beach! Just remember, use caution when doing/enjoying activities that may apply pressure to the areas of your body where your battery and leads are…for example, when getting a massage/acupuncture/acupressure. Simply let your therapist know, then relax and enjoy!
Battery Life – Typically, a newer SCS battery is rechargeable and will last ten years or more with proper care. Batteries will have to be replaced eventually and will require a simple outpatient procedure to do so.
With that short list of limitations, isn’t it fantastic to think of all the things you can do with your neuromodulation device, now that you are feeling better with less pain?