ILC's Treatment for Lumbar Osteoarthritis (Spondylosis)
Having been adopted in over 54 countries globally,
the "Cellgel Method" for treating lower back pain
is now available in Japan
For those who have been told it was impossible to operate,
For those who have had recurrence of pain post-surgery,
A low-risk, outpatient treatment is now an option for you.
Table of Contents
This page provides information on the main symptoms and causes of lumbar osteoarthritis, spondylosis and our treatment procedures. The information includes the method of treatment, treatment time, and information about insurance. We use the Cellgel method, which is one of the most advanced methods in the world, and the characteristics of this method are also described in detail.
Please read this page especially if you have been told that you cannot be cured without surgery, if you have had surgery in the past but have not improved, or if you got better after surgery but the symptoms have recurred.
What is lumbar osteoarthritis?
Spondylosis is a broad term given to degeneration of the spine. Osteoarthritis is common cause of spondylosis and is a condition where age-related changes cause the formation of bone spurs called osteophytes, leading to a deformation of the spine. As the deformation progresses, it gradually transitions to spinal stenosis. The main symptoms are coldness and numbness in the legs, and the inability to walk for prolonged periods of time.
Main symptoms of lumbar osteoarthritis
Dull, sluggish, and heavy pain in the lower back and buttocks often occurs when getting up in the morning, getting up after rest or when tired. Pain and other symptoms may extend to the thighs and calves. Pain sometimes occurs when sitting for long periods of time.
If the degeneration is advanced, intermittent claudication, numbness, sensory and mobility problems, and other neurological symptoms due to spinal canal stenosis may occur.
Causes of lumbar osteoarthritis
Factors such as aging, work environment, and exercise lead to the following:
- Intervertebral disc degeneration
- Instability of the lumbar spine
- Bone deformation due to contact between lumbar vertebrae, formation of bone spurs
The progression of these deformities and degenerations causes damage to the bones, intervertebral discs, and nerves, resulting in inflammation, which in turn causes pain.
Along with this deformation and degeneration of the bones, surrounding joints and ligaments also degenerate. As the deformity progresses, the spinal canal and nerve pathways become narrowed, resulting in spinal canal stenosis, spondylolisthesis, and scoliosis.
What are the effective treatments for lumbar osteoarthritis?
Generally, osteoarthritis is first treated with conservative therapy. If symptoms do not improve with conservative treatment and are prolonged, surgery is often suggested.
Surgical methods to reduce pressure on nerves are often used; spinal fusion, in which muscles and ligaments are removed and unstable bones are fixed with screws, or endoscopic surgery: shaving a portion of the lumbar spine and remove enlarged ligaments to remove the pressure. However, sometimes the inflammation does not subside and does not improve after surgery, or the pain recurs. Surgery is not a fundamental treatment as the cause of the pain may not only be related to the spine or intervertebral disc, but also other factors such as body constitution, muscles, and ligaments.
With osteoarthritis and spondylosis, pressure on the nerves and worsening of symptoms are believed to be caused by deformation of the intervertebral discs.
Therefore, our clinic believes that if the deformation of the intervertebral disc can be controlled, inflammation related to nerve compression, such as bone deformation and hypertrophy of the ligaments, can be prevented.
As a treatment for this, disc repair treatment using the Cellgel method restores disc function by repairing the torn annulus fibrosus and replenishing the water content of the nucleus pulposus inside.
The treatment can be performed as a one-day procedure. Local anesthesia is given to the lower back, a needle is inserted into the disc, and a chemical solution is injected.
The treatment takes about 25 minutes and patients can go home after resting for about an hour.
The removal of the bone and part of the disc that is compressing the spinal canal relieves pressure on the spinal canal, but the spine becomes unstable, so an artificial disc is inserted and the bone is secured with a metal device called a bolt and rod.
Since many of our patients come from far away,
we are happy to give free consultations to see which treatment is best for you
We'll diagnose your MRI images for free！
Treatment at ILC
There are four main treatments at our clinic.
As mentioned above, the root cause of each back pain disease is "inflammation and deformation due to aging of the intervertebral discs." Although the four treatment methods have different features and advantages, we would like to first introduce the "Cellgel method," which is the only one capable of intervertebral disc repair.
The Cellgel Method
The Cellgel method is an advanced treatment for low back pain that has been implemented in more than 54 countries worldwide, predominantly in Europe.
As with other treatments, it does not decrease the disc volume, and since the drug remains in the disc as a gel-like implant after treatment, the disc can be preserved. Recent studies have also shown that the volume of the disc increases after treatment.*1
It is also thought that by repairing the disc and preventing leakage of the Nucleus Pulposus, the disc itself will restore its normal function with its own regenerative ability (*2).
It is particularly recommended for patients who are concerned about the risk of conventional disc surgery (MED, PELD, etc.).
*1 Source: European Journal of Radiology 109 (2018) 101–107 , Efficiency of an ethyl alcohol gel in symptomatic disc hernation
*2 Source: International Journal of Spine Surgery Vol. 15 Appendix 1 from regenerative treatment of disc degeneration
"Very good or good results were obtained in 202 (91.4%) of the 221 patients in group A. Of the 44 patients in group B, 37 patients (84%) presented very good or good results and in 9 (82%) of the 11 patients of group C, we obtained similar results. There was no allergic complication in any of our patients. Long-term follow-up magnetic resonance showed a dramatic reduction in hernia volume."
- Dr. J. Theron, one of the world's leading experts in the treatment of Celgel method, from his research article "Percutaneous Treatment of Lumbar Intervertebral Disk Hernias With Radiopaque Gelified Ethanol - A preliminary study."
Actual Treatment Images of the Cellgel Method
Fluoroscopic image view from the back
Fluoroscopic image view from the side
Fluoroscopic image view from the side
Fluoroscopic image view from the back
Merits of Cellgel
- Possibility to repair intervertebral discs where unable to using surgical or laser treatment
- As the disc is repaired, the disc itself regains its original normal function through its own regenerative ability
- The Cellgel method uses local anesthesia over general anesthesia used in conventional surgery, making it less burdensome on the body
- Treatment is done with a thin needle, so the wound is minimal and recovery is rapid
- Treatment is very short, allowing for outpatient day treatment
- Safe, modern treatment proven in more than 54 countries around the world
Flow Cellgel Treatment Process
MRI and X-rays will be taken, followed by a doctor's diagnosis.
If the diagnosis proves the Cellgel method suitable , treatment can begin that same afternoon.
After entering the treatment room and administering local anesthesia to the lower back, a needle is inserted into the intervertebral disc identified in the examination.
A contrast scan is performed to confirm the location of the damaged disc.
The Cellgel drug is administered to the damaged area while confirming the location of the disc with a fluoroscopy device.
Once the drug has been absorbed, the needle is removed and the bleeding is stopped.
After the treatment, the patient rests in a private room for about an hour, and then allowed to go home after the post-treatment examination.
*Resting time depends on the patient's symptoms and condition.
Price Cost of Treatment for the Cellgel Method
|1 disc||2 discs||3 discs||4 discs||5 discs|
|Treatment Cost||1,420,000 JPY||1,530,000 JPY||1,640,000 JPY||1,750,000 JPY||1,860,000 JPY|
*The prices listed are inclusive of tax.
*All medical and diagnostic costs, including MRI and other tests, as well as medical translation and interpretation fees, are all included in the treatment costs listed above.
*If the same treatment is performed again within 3 years after the first treatment, fees will be reduced by half.
*The treatment is not covered by the Japanese health insurance, one must privately bear the entire cost of the treatment.
*Payment by credit card (Visa, MasterCard, UnionPay) is accepted for the treatment costs only.
*If you also wish to receive rehabilitation (specialized rehabilitation for back pain), payment can be made by bank transfer.
*You can receive a tax refund by filing a tax return for medical expenses.
FAQ FAQ about spondylosis / lumbar osteoarthritis and treatment
QWhat's the difference in the reccurence rate between Cellgel and conventional surgery?
ASurgical procedures, which began in the 1960s, aimed to remove and sometimes fix deformed bones and herniated tissue. However, new bone damage caused by screws and the lack of fundamental treatment (repair of the intervertebral disc annulus fibrosus) resulted in the appearance of additional back pain and recurrence rates.
QHow is the disc to be treated determined?
AThe doctor will spend about 30 minutes with the patient while looking at the MRI and X-ray images to determine the cause of the condition, determine the treatment area, and explain the corresponding treatment method to the patient. MRI images show the main factors that contribute to back pain (disc, nerve, ligament, and joint), such as changes in shape, pressure on the nerve, presence or absence of damage, and inflammation. The x-ray image mainly confirms the condition of the bones.
QWhy is the Cellgel method applicable to cases where surgery showed no improvement?
ADuring surgery for disc herniation, the prolapsed herniation is removed, but the damaged disc remains intact. As a result, fresh nucleus pulposus components leak from the damaged disc and inflammation persists. On the other hand, our treatment can treat the disc injury itself, thus suppressing inflammation by reducing the fresh leakage of nucleus pulposus components.
QMy back pain may temporarily worsen after treatment. How long will it last?
AThe reason for the lower back pain is that spinal ligaments that have been compressed are stretched; the lower back pain lasts for about two weeks and then subsides.
QWhat level of exercise can I perform after treatment?
AGeneral recreational exercise and sports can be done without any problem. For professional athletes, the possibility of new disc damage is high and should be discussed in consultation with a doctor.
QPlease tell me about what I should be cautious about after treatment.
ADuring the first few days after treatment, the patient should rest and avoid prolonged sitting, heavy lifting, twisting, bending, or strenuous exercise. Patients should be able to perform routine tasks one week after treatment and should be able to perform light exercise by the second week. Weight training is allowed after 3 months.
QIs the treatment covered by the Japanese national health insurance?
ANo, it is not covered by the national insurance. If you have life insurance, you may be eligible. Please feel free to consult our staff regarding this matter.
QHow long must I wait to be able to walk after treatment?
AIt is an outpatient/day treatment, so you can walk about an hour after the surgery.
QHow many doctor visits do I need to make before treatment?
AWe require an MRI to be taken within three months for remote diagnosis, either with our affiliated clinic or from data sent by you. You can receive treatment on the same day after phyiscal diagnosis. You may also request only the diagnosis and come back only for the treatment at a later date.
QCan I fly immediately after the treatment?
AIf there are no problems after the treatment, you may fly. If there is any pain after the treatment, flying may not be recommended depending on the doctor's evaluation.
QWhat should I be cautious of when I am diagnosed with spondylosis / lumbar osteoarthritis?
AOnce you have been diagnosed with osteoarthritis and/or spondylosis, the first step is to prevent further disc and bone degeneration. If you perform a lot of back-straining activities or tasks, reduce the frequency of such movements, and listen carefully to your doctor's advice to determine what you should do next.
QHow should I sleep if I am diagnosed with spondylosis/lumbar osteoarthritis?
AIf you sleep on your back, place a cushion under your knees, or curl up slightly on your side for more comfort.
QWhat is the difference between spondylosis/lumbar osteoarthritis and disc herniation?
Disc herniation is a case in which the nucleus pulposus in the disc protrudes outward and compresses the nerve, causing pain. Spondylosis is a degeneration of the spne caused by osteoarthritis; where pain is caused by degeneration of the disc, thickening of the ligaments, or the appearance of bone spurs.
From osteoarthritis, the spondylosis may progress to disc herniation and spinal canal stenosis.
QCan spondylosis/lumbar osteoarthritis be cured without surgery?
AUnfortunately, there is no complete cure for bone deformities.
It is possible to reduce inflammation and prevent the worsening of pain and progression of symptoms by relieving symptoms and improving the overall physical condition of the patient.
QAre there medications to cure spondylosis / osteoarthritis?
Medication will not fundamentally cure the disease.
However, medications may be prescribed to relieve pain and improve blood flow. For severe pain, it may be necessary to take painkillers. Patients who have been taking medication for a long time may experience other pain and side effects if the medication is abruptly stopped.
QCan I continue working if I have spondylosis / osteoarthritis?
It is possible to continue, depending on the severity of the symptoms.
However, if your job involves a lot of desk work or heavy labor, you need to refrain from such work as much as possible, as it is hard on the lower back.
If it is difficult to change your work environment, consider improving your physical condition, posture, and muscle strength. If these methods improve the condition, we recommend that you continue to use them.
If there is no improvement, we recommend that you consult a doctor and receive a diagnosis.
ILC Rehabilitation X Lumbar Osteoarthritis Treatment
Although the Cellgel method can repair and regenerate the disc itself, and other treatment methods we offer can fundamentally heal the disc; it is possible that the cause of back pain is not only the disc, but also muscles, joints, and ligaments that are affected by the disc.
In cooperation with our rehabilitation specialists, we recommend treating back pain caused by muscles, joints, and ligaments together.
We also offer a short-term intensive program for patients who live far away or overseas.
ILC's Low Back Pain Treatment
Improve back pain disorders/
symptoms in relation to the nerves
ILC's Rehabilitation Program
Specialized Low Back Pain Rehabilitation
Improve back pain disorders/symptoms in
relation to the joints, muscles, ligaments
ILC's Specialized Back Pain Rehabilitation
Our Rehabilitation Approach to Lumbar Osteoarthritis
Degeneration of the spine is caused not only by age-related changes, but also by habitual poor posture in daily life and work. As long as the habitual stress continues, the progression of lumbar degeneration cannot be controlled.
Once deformity occurs, it is difficult to return to the original state through rehabilitation, but it is possible to suppress the progression of degeneration.
In our rehabilitation program, we intervene in the osteoarthritis to alleviate pain and to control the degeneration.
Pain relief is achieved through exercise therapy to eliminate pressure on the lower back, and acupuncture and moxibustion therapy to alleviate the inflammation that causes pain.
When pain due to inflammation is prolonged, oxidative stress is often elevated, nutritional conditions in the body worsen, so we provide dietary therapy and other treatments to improve symptoms.
ILC's Specialized Back Pain Rehabilitation
How to Evaluate Lumbar Osteoarthritis
In order to understand the state of osteoarthritis, a consultation is held with the doctor to determine the damaged site and shape based on imaging findings, and to determine the area under stress.
Using the findings as a reference, we will evaluate the aggravating and mitigating factors of the symptoms in the posture and movements of daily life while actually moving the body slowly.
Aggravating factors are defined as movements that should not be performed, and mitigating factors are symptoms that can be alleviated by doing certain body movements. We will comphehensively evaluate these factors with muscle strength and stiffness, and explore the nature of the symptoms.
If necessary, a Spinal Mouse is used to evaluate the condition of the vertebrae caused by changes in posture.
ILC's Specialized Back Pain Rehabilitation
Rehabilitation Treatment for Lumbar Osteoarthritis
To prevent osteoarthritis of the lumbar spine, lifestyle changes are needed to reduce the deterioration of the intervertebral discs.
Because intervertebral discs are prone to deterioration due to poor nutritional conditions, it is necessary to maintain good blood circulation around the discs.
Poor blood circulation can be caused by poor posture and lack of exercise. Poor posture causes the muscles in the lumbar back to tense and blood flow to the area around the intervertebral discs to deteriorate. Continued poor blood flow also leads to poor disc nutrition, which can lead to degenerative changes in the discs as they age.
When disc degeneration is progressing, the disc is prone to irritate the nerves that cause pain. In addition to excessive stress, such a condition causes excessive production of reactive oxygen species (ROS).
ROS is a partially activated form of oxygen taken into the body. While ROS work as a cellular transmitter and immune function, excessive production of ROS is a substance that is greatly related to lifestyle-related diseases such as cancer and cardiovascular diseases. The state of excessive presence of reactive oxygen species in the body is called oxidative stress.
Reactive oxygen species cause oxidation and damage to intervertebral discs. Antioxidant supplementation is necessary to control oxidative stress levels to normal levels.
Recent studies have proven that enzyme intake reduces oxidative stress better than the typical antioxidants, vitamins A, C, and E.
Since oxidative stress causes disc degeneration, which is the cause of herniated discs and spinal canal stenosis, our facility offers therapeutic diets (such as brown rice meals and enzyme drinks) as part of our residential rehabilitation program.
- Lifestyle Guidance
ILC's Specialized Back Pain Rehabilitation
Treatment Period for Lumbar Osteoarthritis
Osteoarthritis is characterized by persistent low back pain for 12 weeks or more and has tendency to have recurring back pain.
Degeneration and pain can result in a limited range of motion in the lower back and treatment time may vary.
We aim to achieve 100% effectiveness of treatment while incorporating the latest technology, so we spend at least 30 minutes with each patient to carefully and meticulously examine the patient's concerns in order to make a proper diagnosis and propose the most suitable treatment methods.
We are certain to find a way to alleviate or eliminate the pain and numbness you are experiencing, so please do not give up and give us a call instead!
- Tadaaki Minowa, Clinic Director