Column Today’s Treatment Case: CASE-No.58｜ILC International Low Back Pain Clinic (Tokyo) Column

This is the case of a patient who decided to get treated at our clinic after receiving block injections which failed to cure the pain altogether.

Patient

Female in her 60s

Patient’s progress to date

In January 2023, pain in the lower back and left lower limb and numbness appeared after lifting a sewing machine.

She visited an orthopedic surgeon who diagnosed her with a herniated disc.

She received block injections, which helped a little, but not completely, so she made the decision to consult at our clinic.

Symptoms before treatment

• Pain level before treatment:

Lower back, lower limbs, numbness, hips

Pain level 3 5 5 3

(with no pain at all rated at 0, and the maximum possible pain rated at 10).

Main areas of pain – lower back and left lower extremities.

Forward bending: symptoms are more pronounced in the lower left extremity.

Backward bending: pain in the lower back

Additional details on the examination

Daily activities

Symptoms are more pronounced when bending over.

She also has some difficulty in standing up, sitting in a squatting posture, sitting for a long time, and lifting heavy objects.

She has difficulty walking more than 500m but can walk between 100 and 500m.

MRI Imaging & Diagnostic

• L2/3, 3/4, 4/5, and 5/s show signs of disc degeneration
• L4/5s: herniated disc

・L3/4, 5/s – disc degeneration, both discs are cracked on the left side, so the patient is deemed prophylactic.

・4/5 – Herniated disc observed, possible cause of pain and numbness

Based on the above examination and imaging findings, we proposed the following treatment:

Treatment

The Cellgel procedure was performed on L3/4, 4/5, and 5/S.

After the Discogel is injected into the disc.

The treatment itself took about 30 minutes.

After the treatment, the patient recuperated in the recovery room and was able to walk home.

Treatments at our Clinic

Here is some additional information about the Cellgel method that we have introduced here.

Cost of the Cellgel method: 1,420,000 yen per site (including tax) to 1,860,000 yen per 5 sites (including tax)

Cost for this patient’s case: 3 areas treated with Cellgel = 1,640,000 yen (including tax)

Risks and side effects of the Cellgel method:

Transient pain may occur after treatment. Nerve damage is a never a zero possibility due to the very nature of the treatment, but there have been no reports of damage in either report cases or in 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 has lost its volume almost completely, it may not be possible to perform the treatment. The doctor will consult with you at the time of your visit to determine the best treatment option for your condition.

Please refer to the following links for more information on the Cellgel method:

Written by Dr. Naoki Yoshida, Administrative Director