Column Case Report No. 144｜ ILC International Low Back Pain Clinic (Tokyo) Column
April 12, 2024
The patient:
A male patient in his 80s
The patient’s medical history to date
In his 50s, while trying to go to the toilet, he became unable to move due to lower back pain and had to call an ambulance.
In 2022, while walking, he suddenly became unable to move his left lower limb and had to take frequent breaks to continue walking.
He visited a local orthopedic clinic where he was diagnosed with lumbar spondylolisthesis. He was given block injections and medication, but to no effect.
He came to our clinic seeking treatment.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Lower limbs Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 1 | 9 | 8 | 4 |
No pain at all is rated as 0, and the maximum possible pain is rated as 10.
Main pain area: left lower limb
Bending forward: Tingling in both lower limbs
Bending backward: No change
Lasegue test: Negative
Pressure pain: L4/5 on the right
Additional explanations on our clinic’s medical examination
・Daily activities
The pain is at its worst when standing for long periods of time.
His walking ability is about 100m or less.
Images and findings
- Spondylolisthesis at L4
- Spinal canal stenosis at L2/3, 3/4, 4/5
The above findings were also observed on the imaging.
・Spinal canal stenosis at L3/4 and 4/5 were observed, and are highly likely to be the cause of the main symptoms.
・L2/3 – Spinal canal stenosis was also observed, but the effect of the Cellgel method was limited due to the large impact of the bone spurs.
Treatment
After consulting with the patient, the Cellgel method was performed on L3/4 and 4/5.
The treatment was performed by Dr. Minowa.
This is an image of the patient’s back after the Discogel injection.
The treatment took about 20 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
