Objective To investigate the therapeutic rate and side effects of different doses of Triamcinolone Acetonide to treat prolapsed lumbar disc. Methods 32 patients with prolapsed lumbar disc were randomly divided into two groups ( n =16). Epidural space was punctured at L3-4 interspace at lateral position, then a epidural catheter was inserted 4 cm distally. 5 min after injection of 3 ml of 1.5% lidocaine, group A or B medication was administered epidurally. Group A contrained Triamcinolone Acetonide 20mg + lidocaine 20mg + vitamin B_ 12 1000?g diluted to 8ml with saline, Group B contained Triamcinolone Acetonide 40mg + lidocaine 20mg + vitamin B_ 12 1000?g diluted to 8ml with saline. The patients were allowed to supine position after 10min in lateral position. 3 injections was made at interval of 3 days, patients were kept in bed for 3 weeks. Results The cure rate at group A and B were 100%. Side effects at group A and B were 31% and 75%, there were statistical significant difference ( P

BACKGROUND: It is often found in the clinic that apart from oppression and instability, there is much difference in sensibility and motion function recovery in patients who have similar imageological changes. Studies show that adhesion in the dura mater of spinal cord, traction of fibrous strip,traumatic scar, malacosis and cyst are the main causes.OBJECTIVE: To investigate the clinical effects of spinal decompression and nerve tissue implantation for obsolete incomplete paralysis.DESIGN: Self-control observation.SETTING: Department of Orthopaedics, Changhai Hospital of Second Military Medical University of Chinese PLA.PARTICIPANTS: We selected 28 patients with traumatic obsolete incom plete paralysis from the Department of Orthopaedics, Changhai Hospital of Second Military Medical University of Chinese PLA, from June 1994 to August 2002. Injured vertebral segments were T7-T9 (5 cases), T10-T12 (12 cases), and L1-2(11 cases). Sixteen patients had undergone decompression, fusion and internal fixation. Thirteen cases of them had undergone posterior decompression and pedicle screw internal fixation. The internal fixation devices had been removed in 7 patients before this procedure. Six cases of traumatic obsolete incomplete paralysis had been treated by hyperbaric oxygen. According to the classification of Frankel, 16 cases were degree B and 12 cases were degree C.METHODS: The dura mater of spinal cord was opened, and the fibrous bands adhering to the spinal cord from arachnoid, pia mater spinalis, ligamenta denticulatum, initial part of nerve root were complete relieved. Then the spinal cord with scar fibers contracted was opened by 3-6 incisions,which were 0.1-0.2 mm deep and longer than the scar part. Cyst found in the spinal cord in 6 cases was opened and the liquid in it was sucked. After that, we denuded spineurium and perineurium of the autogenous sural nerve graft, making the texture and appearance of the nerve look like cauda equine. The nerve was lined in several strips and longitudinally implanted into the incised spinal cord and cyst, and then it was sutured with pia mater spinalis with 9-0 scatheless wire. Finally the endorachis was sutured or covered by sacrospinal muscle.RESULTS: Sixteen cases were followed up for an average of 2.5 years, and all the patients entered the result analysis. The sensibility and motion func tion increased above one grade. Eleven patients who had suffered gatism had obvious progress. The strength of main muscle was increased by 2 grades and reached grade 4 in 16 cases, and walking capability was recovered. In 10 cases it was increased by 1 grade Only sensation had progress in 2 cases.CONCLUSION: Relieving adhesion in the endorhachis, incising the cicatricial spinal cord and bridging the autogenous peripheral nerve have good therapeutic results for gatism and recovering the muscle power of the ex-tremities for the patients with traumatic obsolete incomplete paralysis.