AIM: Both of extradural injection (EI) and three dimensional rectification apparatus treatment (TDRAT) are best conservative therapies of lumbar intervertebral disc protrusion (LIDP). To compare the curative effects of above-mentioned two therapies and probe into the possibility of integrated therapy of them. METHODS: 180 patients with LIDP between January 2003 and January 2005 were selected from the Department of Rehabilitation Medicine, Chinese PLA General Hospital and randomly divided into three groups: EI group, TDRAT group and integrated group with 60 patients in each group. Patients in the EI group received epidural injection of mixed liquor of 20 g/L lidocaine, citicoline, vitamin B12 and dexamisone once every 5 days for totally 4 times. The 3-D rectification apparatus was adopted to treat patients in the TDRAT group once a week for totally twice. Patients in the integrated group received integrated treatment of both former groups. The 3-D rectification apparatus was used once after every two or three times of injection. The pain scores at 3 and 6 months before and after the treatment, clinical presentations and the curative effects of 3 months after treatment were compared among all groups. Evaluation criteria of the curative effects: (1) healed -- the patients could return to work with no back leg pain and the clinical representations were negative. (2) Effective -- patients can afford light work with back leg pain essentially disappeared and 2 or 3 signs turned to negative. (3) Improved -- patients need further treatment with 1 back-leg pain relieved and one sign turned to negative. (4) Ineffective -- no alleviation. RESULTS: All patients accomplished the treatment and index-evaluation, and were involved in the analysis of results. (1) Three months after treatment, the scores of pain evaluation were reduced in three groups than those before treatment, and that in the integrated group was more obvious Chi2 = 2.12, p < 0.01). Six months after treatment, the pain symptom in most patients of all groups were controlled, especially in patients of integrated group, which was greater different from that in the former two groups (Chi2 = 4.02, p < 0.01). There were significant differences between the EI group and TDRAT group as well as between the integrated group and EI group (Chi2 = 5.61, 6.15, p < 0.05). (2) Four signs in 3 groups after treatment were obviously ameliorated than those before treatment, especially the positive rate in straight-leg raising test, there were significant differences between integrated group and EI group as well as the integrated group and TDRAT group (Chi2 = 9.23, 9.13, p < 0.01), while no marked difference was found between EI group and THRAT group (Chi2 = 11.6, p > 0.05). (3) The effective rate in EI group, TDRAT group and integrated group, was 75%, 72% and 92% respectively, and there were significant differences between integrated group and EI group, integrated group and TDRAT group (Chi2 = 6.25, 6.03, p < 0.01), while there was no obvious difference between EI group and TDRAT group (Chi2 = 8.62, p < 0.05). CONCLUSION: Both of extradural injection and 3-D rectification apparatus treatment have good effects on LIDP, while the healing rate of integrated treatment with above-mentioned therapies is the best, which has high negative rate in clinical representations and better prognosis without obvious side-effects. High curative effect can be achieved by integrating EI and TDRAT.

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