Column Case Report No. 129｜ ILC International Low Back Pain Clinic (Tokyo) Column
January 26, 2024
Patient Case
The patient
A male patient in his 40s.
The patient’s medical history to date
In his 20s, the patient was diagnosed with herniation and received block injections, which improved his condition.
In May 2023, he developed pain in his right shin after carrying a package. He went to physical therapy and felt a little better, but on the same night, he had severe pain in his lower limb and visited a local orthopedic surgeon who prescribed painkillers.
Currently, the pain is half of what it was at its peak and he is able to walk.
The patient came to our clinic for treatment.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 3 | 8 | 8 | 8 |
No pain at all is rated as 0, and the maximum possible pain is rated as 10.
Main areas of pain: lower back, both buttocks
Forward bending: Numbness in the left buttock
Backward bending: numbness in the left buttock
Lasegue test: positive at a 60° angle on the left, numbness in the left lower limb
Point of tenderness: pain around the spinous process in L4/5
Additional explanations on our clinic’s medical examination
・Daily activities
Pain increases with forward/backward bending and when carrying a heavy load.
There is no problem with the walking ability.
Imaging and findings
- L1/2, 2/3, 3/4, 4/5, 5/s – disc degeneration
- L2/3, 5/s – disc herniation
The above findings were also observed on the imaging.
・L2/3 – narrowing of the right intervertebral foramen due to disc herniation, which may be the cause of symptoms on the right side.
・L5/s – Stenosis of both intervertebral foramina due to disc herniation, which is also one of the probable cause of the main symptoms.
Treatment
After consultation with the patient, a PODD procedure was performed on L5/s.
Due to previous work commitments, the patient did not have time to schedule a rest period after, so only a PODD treatment was performed this time.
Dr. Kono performed the treatment.
This is an image of the needle inserted into the intervertebral disc.
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
