Column Case Report No. 127｜ ILC International Low Back Pain Clinic (Tokyo) Column
January 19, 2024
Patient case
The patient
A male patient in his 40s.
The patient’s medical history to date
In 2014, the patient suffered a burst fracture of the lumbar spine caused by an injury at work, and underwent fusion surgery between vertebrae L1 and L4.
In November 2023, since he often had to drive for long hours as part of his job, he began to exhibit symptoms such as back pain, difficulty in getting up and down, as well as numbness in his right lower limb.
Although a revision surgery was recommended to him, he instead decided to come to our clinic by his own choice.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 4 | 0 | 4 | 0 |
No pain at all is rated as 0, and the maximum possible pain is rated as 10.
Main areas of pain – buttocks, numbness in the right lower limb.
Forward bending: aggravation of the back pain
Backward bending: aggravation of the back pain
Lasegue test: positive at a 90° angle.
Point of tenderness: pain on 4/5 on both sides
Additional explanations on our clinic’s medical examination
・Daily activities
Aggravation of the symptoms when standing up after prolonged sitting.
Difficulty in extending one’s lower back.
The patient is able to walk up to 500m without any problem.
Imaging and findings
- L4/5, 5/s – Intervertebral disc degeneration
- L4/5, 5/s – Intervertebral foramen stenosis
- L1 to 4, Post fusion surgery
The above findings were also observed on the imaging.
・L4/5, 5/s – Intervertebral foramen stenosis caused by disc degeneration was observed, and is the most likely cause of each symptom.
Treatment
After consultation with the patient, the Cellgel Method was performed on L4/5 and 5/s.
The treatment was performed by our administrative director, Dr. Minowa.
This is an image of the needle inserted into the intervertebral discs.
The treatment took about 30 minutes.
After resting in the recovery room, the patient was able to walk home by himself.
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
