Column Treatment Case Report No. 114｜ ILC International Lumbago Clinic (Tokyo Clinic)
2023.11.13
Patient case
The patient
A female patient in her 60s.
The patient’s medical history to date
In August 2022, a posterior fusion surgery was performed on L2, 3, 4, and 5 for spondylolisthesis. The postoperative period was satisfactory.
In August 2023, she developed a tingling sensation from her lower back and right buttock to her toes. She was suggested to undergo surgery again in L5/s.
Since she did not wish to undergo surgery again, she decided to come to our clinic.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 8 | 8 | 6 | 6 |
No pain at all is rated as 0, and the greatest possible pain is rated as 10.
Main pain areas – buttocks, right lower extremity
Forward bending: no change
Back bending: no change
Lasegue test: pain in the right lower leg at 45 degrees on the right side
Point of tenderness: iliac crests on both sides around S3
Additional explanations on our clinic’s medical examination
・Daily activities
Symptoms are more severe in half-sitting posture and when standing.
The patient’s walking ability is about 50 m. She is unable to walk without the use of a walker.
Imaging and findings
- L1/2 – spinal canal stenosis
- L2/3, 3/4, 4/5 – post fusion surgery
- L5/s – anterolisthesis
The above findings were also observed on the imaging.
・L1/2 – spinal canal stenosis was observed, and there is a possibility of pain in the lower back area.
・L2/3, 3/4, 4/5 – post fusion surgery, not treatable
・L5/s – right intervertebral foramen stenosis due to spondylolisthesis, which is the most likely cause of the main symptoms.
Based on the examination and imaging findings, we proposed the above treatment.
Treatment
After consultation with the patient, the Cellgel Method was performed on L1/2 and 5/s.
The treatment was performed by our administrative director, 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
