Column Treatment Case Report No. 64｜ ILC International Lumbago Clinic (Tokyo Clinic)
April 24, 2023
The case of a patient with foraminal stenosis caused by disc herniation
The patient
A female patient in her 60s.
The patient’s medical history to date
2 years ago, the patient began to have pain in her lower back.
The pain aggravated when she started getting massages.
She visited an orthopedic surgeon and was treated with medication, but since the pain did not get any better, she decided to visit our clinic.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 7 | 7 | 5 | 6 |
No pain at all is rated as 0, and the maximum possible pain is rated as 10.
Main areas of pain and numbness: lower back, right thigh, back of the knee. Numbness in both toes.
Bending forward: no change
Bending backward: no change
Lasegue test: negative
Point of tenderness: none
Additional explanations on our clinic’s medical examination
・Daily activities
It is painful when she wakes up in the morning.
Some difficulty in standing up, prolonged sitting, and lifting heavy objects.
The patient’s walking ability is unaffected.
Imaging and findings
- L4/5 disc herniation leaning to the right side
- L1/2, 2/3, 3/4, 4/5, 5/s disc degeneration
- L3/4 foraminal stenosis on both sides, and on disc 4/5 foraminal stenosis on the right side
The above findings were also observed on the imaging.
・L2/3 and 3/4 – disc degeneration and foraminal stenosis were observed, suggesting a preventive approach.
・L4/5 – disc herniation leaning to the right side, with a strong stenosis of the right intervertebral foramen, which could be the probable cause of the main symptoms of pain and numbness.
Based on the examination and imaging findings, we proposed the above treatment.
Treatment
After consulting with the patient, the Cellgel Method was performed on L2/3, 3/4 and 4/5.
This is an image of the patient’s back after the Discogel injection.
The treatment took about 25 minutes.
After resting in the recovery room, the patient was able to walk home by herself.
Our clinic’s treatment method
Additional information about the Cellgel method we have introduced in this column.
Cost of the Cellgel method: 1,320,000 yen per area (including tax) to 1,760,000 yen per 5 areas (including tax)
Risks and side effects of the Cellgel method: Transient pain may occur after treatment. Nerve damage is not a zero possibility due to the very nature of the treatment, but there have been no reports of damage so far in either report cases or publications. There is a very small possibility of allergic reactions to local anesthetics. Symptoms may temporarily worsen during the first week or two after treatment. This is believed to be due to the decompression effect of the implant, which retracts the surrounding tissues. In addition, if the disc is almost completely collapsed, treatment may be difficult. The doctor hold a consultation with you during your visit to the clinic to determine the best treatment option for your condition.
For more detailed information, please refer to the following links:
Blog page explaining the Cellgel Method in an easy-to-understand manner
The Cellgel Method on our treatment methods page
This article was written by the Administrative Director of our clinic
