Column Treatment Report No.159｜ILC International Low Back Pain Clinic (Tokyo) Column
July 17, 2024
The patient
A male patient in his 40’s
The patient’s medical history to date
He first experienced backache when he was in junior high school. Since then, he has had back pain at a rate of about once a year.
In February 2024, he started developing pain in the left part of his lower back, and although the pain had usually subsided up to now, this time it gradually increased in intensity, eventually causing walking difficulties.
He then consulted a local orthopedic surgeon and was diagnosed with disc herniation. There, he was treated symptomatically with rehabilitation and medication.
He came to our clinic seeking a curative treatment.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 6 | 5 | 4 | 8 |
No pain at all is rated as 0, and the greatest possible pain is rated as 10.
Main pain areas: lower back, back of the left lower limb
Forward bending: worsening numbness in left lower limb
Backward bending: Worsening of lower back pain
Lasegue test: Positive on the left at a 60-degree angle.
Tenderness: 4/5 on the left
Intermittent claudication: none
Additional explanation about our clinic’s medical examination
・Daily activities
Symptoms are more severe when the left side is extended.
For example, when the left leg is extended backward when walking.
Imaging and findings
- L5/s- Herniated disc
- L4/5,5/s- Degeneration of the intervertebral disc
- L4/5- Rupture of the annulus fibrosus on the left side of the disc.
The above was also observed on the imaging.
・L4/5 – Disc degeneration and rupture of the annulus fibrosus are the most likely cause of past recurring low back pain.
・L5/s – Narrowing on the left intervertebral foramen due to left disc herniation, which is also one of the most likely causes of the main symptoms.
Treatment
After consultation with the patient, the Cellgel procedure was performed on L4/5,5/s.
The treatment was performed by the clinic administrative director Dr. Minowa.
This is an image of the DiscoGel after injection.
The treatment took about 25 minutes.
After resting in the recovery room, the patient was able to walk home by himself.
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
