Nursing Management of Epidural Spinal Cord Stimulation in a Patient With Chronic Paraplegia: A Case Report

Epidural spinal cord stimulation (E-SCS) is a breakthrough intervention for functional restoration in chronic spinal cord injury (SCI). The nursing role in translating neuromodulation into daily living remains underexplored.

We recently managed the care of a 50-year-old man with American Spinal Injury Association Impairment Scale grade B paraplegia. Interventions ranged from preoperative psychosocial evaluation and education to postoperative outpatient follow-up. For E-SCS mapping, the team utilized a dual-verification approach (electromyography and muscle recruitment). We used a multimodal stimulation strategy (2-100 Hz) and an E-SCS activity diary to facilitate long-term self-management.

At 3 months, the patient's neurological level of injury improved from T11 to L1. The motor score increased by 9 points, and neuropathic pain decreased (NRS 4 to 2). The Barthel Index increased from 60 to 80, and the World Health Organization Quality of Life-BREF score improved from 89 to 110, reflecting enhanced independence.

Nurse practitioners serve as vital clinical integrators. This case highlights how comprehensive nursing management and patient empowerment can effectively bridge complex neuromodulation to sustainable daily living and social reintegration in patients with SCI, suggesting that E-SCS combined with tailored nursing strategies was associated with marked improvements in neurological recovery, motor function, and quality of life in this patient with chronic SCI.