August 8, 2024

The patient

A male patient in his 70s

Name of the main medical conditions

　L4/5 spinal canal stenosis

Intermittent claudication: present

Patient’s medical history to date

　The patient has had numbness and intermittent claudication for over 10 years.

In the past, he was able to walk for 20 to 30 minutes after taking a break, but

he is no longer able to do so.

He had never had back pain so far, even when he was having symptoms due to a compression fracture.

He was having issues because of the numbness.

He came to our clinic with the aim of improving his condition, hoping that the numbness would be alleviated even a little.

Symptoms before treatment

　Numbness and pain in whole area of the lower limbs, from thigh to toes.

Numbness when lying or sitting down.

・Pain levels before treatment

No pain at all is rated as 0, and the maximum possible pain is rated as 10.

Main areas of numbness: lower limbs

　Forward bending: no problem

backward bending: painful

pressure points: right L3/4 positive, L4/5 buttocks, L5/s lower limbs

Lasegue test: Positive on the right at 70 degrees

coughing, sneezing: no exacerbation of the symptoms

Images and findings

• L5 – old compression fracture
• L4/5 – severe spinal canal stenosis, bilateral facet joint inflammation

The above was also observed on the imaging

・Severe spinal canal stenosis at L4/5 was observed, and it is highly likely that this is the cause of the numbness in the entire lower limbs.

Treatment

After consulting with the patient, the Q-Florence method was performed on the spinous processes at L4/5

The treatment took about 65 minutes (15 minutes for anesthesia + 50 minutes for treatment)

After taking a rest in the recovery room, since the patient was able to sit, stand, and walk without any problems, she was able to walk home on her 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 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