Column Case Report No. 81 (Q-Florence Method)｜ ILC International Lumbago Clinic (Osaka) Column
November 16, 2024
The patient
A female patient in her 60s.
Name of the patient’s primary medical conditions
L4/5 Severe spinal canal stenosis
Intermittent claudication: present
The patient’s medical history to date
The patient has had spondylolisthesis for 20 years. She has been using electrical therapy and a corset, but as she was not in continual pain, she failed to seek proper treatment, and instead monitored her condition by doing physical exercises and other measures.
Around November of last year, she began to experience lower back pain and started going to an osteopathic clinic. The symptoms did not ease.
A few months ago, she also began to experience symptoms in her lower limbs. She started taking medication from a local clinic, but since her symptoms did not improve, she decided to come to our clinic.
Symptoms before treatment
Lower back pain, pain in both lower limbs, numbness in both lower limbs.
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 8 | 7 | 9 | 9 |
No pain at all is rated as 0, and the maximum possible pain is rated as 10.
Main area of pain and numbness: lower back to lower limbs
Bending forward: Possible
Bending backward: Difficult
Pressure points:L4/5 on both sides
Lasegue test: Negative
Coughing and sneezing: No aggravation
Imaging and findings
- L4/5 – Severe spinal canal stenosis
- L4 – spondylolisthesis, instability
- L3/4，4/5 – Disc degeneration
The above findings were also observed on the imaging.
・There is a very high possibility that the cause of the main symptoms such as the severe pain and numbness is due to spinal canal stenosis caused by spondylolisthesis.
Treatment
After consulting with the patient, the Q-Florence Method was performed between the spinous processes of L4/5.
After that, the Cellgel method was performed on L4/5.
The treatment took about 85 minutes (25 minutes for anesthesia + 60 minutes for treatment).
After taking a rest in the recovery room, since the patient was able to sit, stand, and walk without any problems, he walked home on his own.
Our clinic’s treatment method
Additional information about the Q-Florence method we have just presented above.
Cost of the Q Florence method: 1,600,000 yen/one site (including tax) to 2,300,000 yen/two sites (including tax)
Cost for this patient’s case: Q Florence method 1 site = 1,600,000 yen (including tax)
Risks and side effects of the Q-Florence method: Although there are no reports of such cases in our own experience or in the literature, there is a possibility of damage to nerves, dura mater, and other surrounding tissues due to insertion of the spacer. There is a very small possibility of allergic reaction to the local anesthetic. There is a possibility of dislocation or fracture of the spinous process. Temporary urinary problems and allergic reactions may also occur.
For more detailed information, please refer to the following links:
Blog page with an easy-to-understand explanation of the Cellgel Method
Our clinic’s page on the Cellgel Method
Blog article explaining the Q-Florence method in an easy-to-understand manner (in Japanese)
Our clinic’s page about the Q-Florence Method (in Japanese)
This article was written by the Administrative Director of the Clinic
