Background and Introduction: Intrathecal sodium Nitroprusside (ITSNP) has shown marked recovery in various causes of paraplegias after proper surgical decompression of spinal cord and stabilization of vertebra. Until now we were unable to the measure of paraplegias’ recovery bedside effectively, either by clinical or SSEP and MEP. We present our work for prediction for paraplegics using ACUPUNCTURE-LIKE TENS (AL-TENS) with ITSNP in various thoracolumbarsacral cases. AL-TENS caused pain relief by well known gate theory at spinal cord by activating A-ALPHA nerve fibers which activates A-DELTA fibers for muscle spindle then pain fibers are inhibited by RENSHAW cells at spinal cord. The present work uses this cascade of various transmissions of nerves via a normal or damaged (complete or partial) spinal cord.

Aims/Study-Design: To prognosticate the POSTITSNP effect by AL-TENS in Thoracolumbarsacral paraplegia cases, Prospective-study.

Material/Methods: 13 paraplegia patients {11 male patients and 3 females, 3 complete paraplegia and 10 partial paraplegia with ZPP (zone of partial preservation) cases taken .in which PREITSNP AL-TENS and POSTITSNP TENS has been done. The mean time for superfusion was 9.69 months. ITSNP administered at a dosage of 0.2 mg/kg bo wt at L3/4 level by 20G LP needle. Pre and post ITSNP was monitored by AL-TENS.

Results: POST-ITSNP AL-TENS showed 23.84% benefit overall and 23.32% in ASIA grading in thoracolumbarsacral paraplegia cases. Complete paraplegia cases didn’t show any change while partial paraplegias (with ZPP) showed 31% recovery in POST-ITSNP TENS and 33.34% in ASIA grading. Thus AL-TENS showed a favorable modality to predict the ITSNP feasibility in thoracolumbarsacral paraplegia cases. If PRE-ITSNP TENS showed 8 mAmp or more there will be no response to ITSNP.

Conclusion: ITSNP with the help of AL-TENS helps us to prognosticate the future outcome.

Keywords: Paraplegias, Intrathecal sodium nitroprusside, Acupuncture-like tens, The 10,000 fold effect