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
L3/4 spinal canal stenosis
Intermittent claudication: present
The patient’s medical history to date
Patient diagnosed with spinal canal stenosis about 20 years ago.
Until then, walking was not a problem, but about 2 years ago, pain and numbness in the thigh appeared when walking.
One year ago, numbness in the sole of the foot (right>left) appeared when walking. Walking time also became about 5 minutes.
When the symptoms became severe, he sometimes felt like he was going to collapse.
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 (more pronounced on the right than on the left)
Bending forward: no problem
Bending backward: Numbness/pain
Points of tenderness: L3/4, L4/5 on the right, L2/3 on the left.
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 foramen stenosis were observed.
・Although disc degeneration and protrusion were observed in L2/3, 3/4, 4/5, and 5/s, it was judged that severe spinal canal stenosis in L3/4 and stenosis of the right foramen were the main causes of the symptoms.
Treatment
After consulting with the patient, the Q-Florence Method was performed between the spinous processes of L3/4.
The treatment took about 70 minutes (35 minutes for anesthesia + 35 minutes for treatment).
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
