Caso clínico: paciente con implante de electrodo medular con paraplejia posquirúrgica y fístula de líquido cefalorraquídeo, importancia de la atención de enfermería

Abstract

Chronic neuropathic pain treatment is currently one of the biggest challenges for health care professionals because of its high impact on quality of life. Neurostimulation therapy is shown as a widely-accepted treatment for patients who have completed the pharmacological treatment options with no results.

Objectives

To show the importance of early detection of post-surgical complication in spinal cord stimulation patients with spinal electrode as well as an adaptation and personalization of nursing care in the event of post-surgical complications.

Method

A case of a woman suffering long-term chronic neuropathic pain following a serious traffic accident and subsequent spinal trauma. A study of a number of possible medical options was undertaken to decide the best outcome for the patient; finally, fitting a spinal electrode implant was decided as the best option, in order to start spinal cord stimulation therapy. Post-surgical paraplegia and cerebrospinal fluid leak were detected and incorrect placement of the electrode was observed on magnetic resonance imaging. A re-intervention was carried out for repositioning.

Results

Nursing care of post-surgical complications, the identification of nursing diagnoses and the ideal adaptation of the initial care plan as well as possible activities and objectives are described.

Conclusions

The importance of the adaptation and personalization of the nursing care plan for patients with postoperative surgical complications must be highlighted.