Column Case Report No. 121｜ ILC International Low Back Pain Clinic (Tokyo) Column
December 11, 2023
Patient Case
The patient
A male patient in his 50s.
The patient’s medical history to date
While in his 40s, the patient had several episodes of back pain that made it impossible for him to get out of bed.
He visited a local orthopedist and was diagnosed with spondylolisthesis. Symptoms have yet to improve.
In the spring of 2023, his back pain gradually worsened.
In August 2023, numbness also developed in his lower limbs. He was recommended to undergo fusion surgery.
He visited our clinic for treatment instead.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 5 | 0 | 8 | 6 |
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, both lower limbs.
Forward bending: no change
Backward bending: slight pain in the lower back
Lasegue test: negative
Point of tenderness: None
Additional explanations on our clinic’s medical examination
・Daily activities
Numbness in the lower extremities when walking.
He can walk some distance if he takes a rest.
Imaging and findings
- L4/5 – spinal canal stenosis
- L2/3, 3/4, 4/5, 5/s – degeneration of the intervertebral discs
- L4, 5 – anterolisthesis
The above findings were also observed on the imaging.
・L4/5 – anterolisthesis and spinal canal stenosis due to disc degeneration, most likely the cause of the symptoms in the lower extremities.
・L5/s – stenosis of the intervertebral foramen due to anterolisthesis, which is also the probable cause of symptoms in the lower extremities.
Based on the examination and the imaging findings, we proposed the above treatment.
Treatment
After consultation with the patient, the Cellgel procedure was performed on L4/5 and 5/s.
The treatment was performed by our administrative director, Dr. Minowa.
This is an image of the disc after injection of the Discogel into the discs.
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
