Column Treatment Case Report No. 11 – ILC International Low Back Pain Clinic (Tokyo) Column

schedule

09.28.2022

The patient

A male patient in his 50s

The patient’s Symptoms

The patient had surgery for a herniated disc (in L5/S) five years ago.

Since June of this year, he has been experiencing pain in his right lower limb.

On a scale of 1 to 10 (1 being the least and 10 being the most painful) his back is at 1, his lower limbs are at 10, and his buttocks are at 5, and the numbness is at 8.

Turning in bed is easy, but sitting for long periods of time or lifting heavy objects is extremely difficult. He also finds it difficult to stand up, wash his face, and even to stand with his knees bent.

Images and Findings

Herniated discs were observed in L2/3, 3/4, 4/5.
Mild tenderness was observed around L5 on the right side during the medical examination.
Neurological symptoms were also observed around L5 on the right side during interview with the doctor and the medical examination.

Treatment

The Cellgel method was performed in L2/3, 3/4, 4/5, and 5/s.

The Discogel injected into the four intervertebral discs is clearly visible.

During the medical examination, the patient was concerned about the pain and other problems that might occur during the operation, so at first, he only wished L4/5 and L5/s to be treated.

During the treatment, we were able to successfully treat L2/3 and L3/4 as well, while considering the patient’s physical strength.

After the treatment, he took some rest in the recovery room and was then able to walk home by his own means.

This time, although he had hernia surgery five years ago, neurological symptoms were observed, so we decided to perform the Cellgel method in L5/S as well.

We took into account both the imaging findings and the findings from the physical examination to reach a decision.