Column Case Report No. 182｜ ILC International Low Back Pain Clinic (Tokyo) Column
December 3, 2024
The patient
A male patient in his 60s.
The patient’s medical history to date
In 2010, the patient injured his lower back after exercising and began to experience difficulty walking. He visited a local orthopedic clinic, where he was diagnosed with disc herniation, and his condition gradually improved over time.
In 2019, the patient began to experience pain in his lower back again.
In 2021, he began to limp on his left leg.
In 2023, he underwent an MRI scan and was diagnosed with spinal stenosis. He continued to take painkillers and use pain patches to see how his condition progressed.
After no improvement in his symptoms, the patient decided to visit our clinic.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 8 | 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, buttocks
Bending backward: no change
Backward bending: increase of pain in the lower back
Lasegue test: positive at 70 degrees on the left side.
Point of tenderness：none
Intermittent claudication: positive after walking for 100m or less.
Additional explanations on our clinic’s medical examination
・Daily activities
Symptoms worsen when in the same position for a long time or after walking for about 100m.
Imaging and findings
- L3/4 – spinal canal stenosis
- L4/5, 5/s – disc herniation
The above findings were also observed on the imaging.
・L3/4 – spinal canal stenosis was observed, and it is highly likely to be the cause of the main symptoms
・L4/5,5/s – disc herniation was observed, and there is also a high possibility that this is the cause of the main symptoms.
Treatment
After consulting with the patient, the Cellgel Method was performed on L3/4, 4/5 and 5/s.
The treatment was performed by our administrative director, Dr. Minowa.
This is an image of the patient’s back after the Discogel 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
