Sacral nerve stimulator

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis certain


Overactive bladder and a history of urge incontinence.

Patient Data

Age: 70 years
Gender: Female

An intact sacral nerve stimulator with the solitary lead correctly projecting over the left-sided S3 foramen. The pacemaker is implanted in the right gluteal soft tissues. Lower lumbar posterior spinal interbody fusion with L4 and L5 transpedicular screws and dual Harrington roads. A decompression laminectomy is present. There are bilateral non-cemented total hip arthroplasties, which appear uncomplicated: bony osteopenia and degenerative changes within the lower lumbar spine and sacroiliac joints.

Case Discussion

Sacral nerve stimulators are also known as neuromodulators. They send a low voltage electrical current to stimulate the sacral nerve and help to alleviate or manage fecal or urinary incontinence. They do not offer a cure. However, they assist in improving the quality of life in these patients. The usual complications are infections and abscess formation, migration, and fracture of the solitary lead. Mechanically they can be affected by cardiac pacemakers, industrial ultrasonic equipment, radiation therapy, metal screening devices, and theft detectors. Magnetic resonance imaging (MRI) was contraindicated in the past in this patient profile. However, the newer devices have significantly improved and are now MRI safe or compatible with recommended pre and post-image acquisition guidelines. If one is unsure, postpone and or perform CT study temporarily until firm information is available regarding the device compatibility. In this instance, the patient required an MRI brain study as requested for neurological symptoms. She had a Medtronic INTERSTIM ICON device, which was MRI compatible, and was changed to MRI safe mode for the study and reactivated after the study. There were no complications during image acquisition.

Disclosure: AsheshI Ranchod has no actual or potential ethical or financial conflict of interest concerning this device. This case is not intended to be a personal endorsement or recommendation of this product.


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