Q: How does a spinal cord stimulator work?

There are several parts to a spinal cord stimulator device. One part of the device includes thin metal wires that are placed in your epidural space, very similar to a pregnant woman getting a labor epidural for labor and delivery. These wires will then be connected to the second part of the device- an implantable pulse generator (IPG). This IPG will help power the leads and send electrical signals through the lead to your spinal cord nerves. These electrical signals help block pain signals traveling to your brain, so that you are now less able to sense or feel the pain.

Q: How do I get approved for a spinal cord stimulator?

If you are an appropriate candidate for this type of device therapy, our office will work with you hand in hand and guide you through the entire process. Keep in mind that many insurance companies require trying some other options first or even obtaining a psychological evaluation. If that is the case, Dr. Zhang and her staff will continue to work with you on your treatment plan towards a spinal cord stimulator. In addition, by working with Louisiana Pain Institute, you have direct access to personnel resources from multiple neuromodulation companies.

Q: What is the process for a spinal cord stimulator procedure?

As part of your treatment plan, Dr. Zhang will help you through the process of finding both the correct diagnosis and an appropriate treatment. You may need to obtain some lab work, additional imaging, or trial other nonsurgical options first. If you are identified as an appropriate candidate for spinal cord stimulation, our office will then work with you and your insurance company for approval. Please keep in mind that certain insurance companies may require a psychological evaluation to help identify factors that can make your implantation more or less successful.

Once approved, you will first need to undergo a trial period of 5-7 days with temporary leads, meaning this stage is completely reversible! These temporary leads will be placed in our state of the art hospital facility under fluoroscopic guidance (live X-ray images), exactly like how the permanent device will be placed. After confirming their exact location, we may do a stimulation test while in the procedural suite. Don’t worry- this doesn’t hurt at all! You may feel a pleasant tingling sensation, which we call paresthesias. Once these temporary leads are in place, we will secure and tape up the leads to your back. We will then transfer you to a postprocedural area to monitor you and go over discharge instructions before letting you leave.

During the initial trial period, please be aware that you will have certain restrictions like limiting heavy lifting, and no contact with water. Someone from our office and/or your medical device company representative will be in touch with you daily to track your progress in terms of pain and activities of daily living.  At the end of your 5-7 day trial period, we will remove your leads in our offices. Don’t worry, this step does not hurt, and often patients complain more about the tape removal than the leads!

Once you have undergone a successful trial period, then we will move forward with the device implant at that point of time.

Q: Are there restrictions after my spinal cord stimulator?

Please note that there will be a short period of restrictions both after your temporary trial period and your permanent device implant. During the initial placement of both stages, you will be unable to have water contact, meaning no showering, pools, or baths for the first few days. We also recommend no vigorous activity or heavy lifting during the initial period, as this may cause your leads to move to a position that may end up providing less effective pain relief. Don’t worry though, these restrictions will not last forever for a permanent implant! With a permanent implant, your body will start to heal, meaning your incision will start to close and your body will start to incorporate the leads in a way that prevents them from moving as much.