Column Case Report No. 14 (Q-Florence Method)｜ ILC International Lumbago Clinic (Osaka) Column
May 18, 2024
The patient
A male patient in his 80s.
Name of the patient’s primary medical conditions
Spinal canal stenosis at L3/4
Intermittent claudication: present
The patient’s medical history to date
The patient was diagnosed with spinal canal stenosis about 20 years ago.
Although he had no problem in walking before, pain and numbness in his thigh appeared when walking about 2 years ago.
Then one year ago, numbness in the plantar region (right > left) developed during walking. The duration of walking became limited to about 5 minutes.
When the symptoms became more severe, he would also experience occasional weakness in his knees.
He came to our clinic seeking improvement of his symptoms.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 8 | 9 | 10 | 10 |
No pain at all is rated as 0, and the maximum possible pain is rated as 10.
Main area of pain: lower back, lower limbs ((right>left)
Forward bending: No problem
Backward bending: Numbness/pain
Points of tenderness: right L3/4, L4/5, left L2/3
Imaging and findings
- L1/2 – Moderate disc degeneration and protrusion were observed.
- L2/3, 3/4, 4/5, 5/s – disc degeneration and protrusion were observed.
- L2/3-Moderate spinal canal stenosis was observed
- L3/4 – severe spinal canal stenosis and right intervertebral foramen narrowing
・Even though L2/3, 3/4, 4/5, and 5/s disc degeneration and protrusion were observed, it is highly likely that severe spinal canal stenosis and right intervertebral foramen stenosis at L3/4 are the main cause of the symptoms.
Treatment
After consultation with the patient, Q-Florence procedure was performed between the L3/4 interspinous processes.
The treatment took about 70 minutes (anesthesia: 35 minutes + treatment: 35 minutes)
After taking a rest in the recovery room, since the patient was able to sit, stand, and walk without any problems, he walked home on his 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
