Important information about Spinal Stimulators.
For patients that have an implanted Spinal Stimulator; RF Ablation
is contraindicated.
A Spinal stimulator has
electrodes that are implanted on the spinal cord and this can cause complications
during RF Ablation. Spinal cord injury occurs from the electrodes interacting
with the RF energy. During RF ablation,
the spinal stimulator electrodes act as an antenna and heat up which can cause
thermal injury to the spinal cord. Spinal cord injury can still occur even if
the device is turned off or partially removed.
The Medtronic website states:
Spinal Cord Stimulation; Indications, Safety,
and Warnings: Contraindications
Diathermy: Do not use shortwave
diathermy, microwave or therapeutic ultrasound diathermy (all now referred to
as diathermy) on patients implanted with a neurostimulation system. Energy from
diathermy can be transferred through the implanted system and cause tissue
damage at the locations of the implanted electrodes, resulting in severe injury
or death.
Warnings:
Sources of strong electromagnetic interference (eg,
defibrillation, diathermy, electrocautery, MRI, RF ablation, and therapeutic ultrasound) can interact
with the neurostimulation system, resulting in serious patient injury or death.
These and other sources of EMI can also result in system damage, operational
changes to the neurostimulator or unexpected changes in stimulation. Rupture or
piercing of the neurostimulator can result in severe burns. An implanted
cardiac device (eg, pacemaker, defibrillator) may damage a neurostimulator, and
the electrical pulses from the neurostimulator may result in an inappropriate
response of the cardiac device.
Images for Spinal Electrodes
Below is a fluoro image of implanted spinal stimulator
electrodes from a recent patient. This patient was scheduled for an SVT ablation.
The patient DID NOT inform anyone about this implanted device and it was not
listed in his H&P or any hospital records. The first indication that the
device was present was in the first fluoro image (please see below).
Although this is a very rare occurrence, it can have
devastating effects on the patient. This is why it is important for us to
screen all patients for any type of implantable stimulator. This procedure had
to be aborted after discovering an implanted spinal stimulator and rescheduled
for a different date and procedure type.
**Stimulator Electrodes highlighted in in yellow
