Column Case Report No. 123｜ ILC International Low Back Pain Clinic (Tokyo) Column
December 18, 2023
Patient Case
The patient
A female patient in her 60s, from Indonesia.
The patient’s medical history to date
In her 20s, she was involved in a traffic accident. She has no memory of the part of her body that was affected.
20 years ago, she felt a pain clutching at her right lower limb.
At a local hospital, she was diagnosed as having a problem in L4/5, but was told there was nothing they could do.
Recently the interval between the periods of pain and of absence of pain has been getting shorter.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 9 | 9 | 4 | 8 |
No pain at all is rated as 0, and the greatest possible pain is rated as 10.
Main areas of pain – lower back and right lower limb.
Forward bending: a little aggravation in the right ankle
Backward bending: a little aggravation in the lower back
Lasegue test: positive at a 70 degrees angle on the right side
Point of tenderness: 3/4 on both sides, 4/5 on the right side
Additional explanations on our clinic’s medical examination
・Daily activities
Symptoms aggravated when standing or sitting on an overly soft sofa.
There is no particular problem with the patient’s ability to walk.
Imaging and findings
- L1/2, 2/3, 3/4, 4/5, 5/s – intervertebral disc degeneration
- L3/4, 4/5, 5/s – stenosis of the intervertebral foramen
The above findings were also observed on the imaging.
・L3/4, 4/5, 5/s- Intervertebral disc protrusion is causing stenosis of the intervertebral foramen, which may be the cause of symptoms in the lower limbs.
Treatment
After consultation with the patient, the Cellgel Method was performed on L3/4, 4/5, and 5/s.
The treatment was performed by our administrative director, Dr. Minowa.
This is an image of the needle being inserted into the intervertebral disc.
Below is an image of the treatment in progress.
This is an image of the needle after insertion into the lumbar vertebrae.
Discogel was injected right after the injection.
The treatment takes 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
