Column Case Report No. 133｜ ILC International Low Back Pain Clinic (Tokyo) Column
February 13, 2024
The patient
A male patient in his 70s.
The patient’s medical history to date
The patient underwent surgery for a herniated disc 15 years ago. The outcome has been satisfactory.
Around 2020, he developed pain in his lower back and right and left lower limbs. He visited a local orthopedic surgeon and was treated symptomatically. He was recommended to undergo surgery to insert a bolt, but he was not very enthusiastic about the idea.
He visited our clinic in search of a curative treatment.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 7 | 7 | 0 | 7 |
No pain at all is rated as 0, and the maximum possible pain is rated as 10.
Main pain area: lower back
Forward bending: no change
Backward bending: no change
Lasegue test: negative
Point of tenderness: near the spinous process at L3/4
Additional explanations on our clinic’s medical examination
・Daily activities
Pain in the lower extremities occur when walking.
Free of symptoms when walking less than 500m.
Imaging and findings
- L2/3, 3/4, 4/5, 5/6, 6/s – disc degeneration
- L3/4 – Spinal canal stenosis
- L4/5, 5/6 – Intervertebral foramen stenosis
- L4 – Mild retrolisthesis
- L4/5 – Postoperative
The above findings were also observed on the imaging.
・L3/4 – Spinal canal stenosis may likely be the cause of the main symptoms.
・L4/5, 5/6 – intervertebral foramen stenosis due to disc protrusion, which also may be the main cause of symptoms.
Treatment
After consultation with the patient, the Cellgel procedure was performed on L3/4, 4/5, and 5/6.
The treatment was performed by Dr. Kono.
The image below shows the DiscoGel after 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
