Column Treatment Case Report No. 105｜ ILC International Lumbago Clinic (Tokyo Clinic)
September 29, 2023
Patient case
The patient
A female patient in her 40s.
The patient’s medical history to date
About 7 to 8 years ago, she started to feel pain in her lower back. She took some pain medicine and it subsided, so she decided to wait and see how things would develop.
In October 2022, the medication became ineffective and she underwent radiofrequency thermal coagulation. Progress was good for six months, but then the back pain returned.
In August 2023, high-frequency thermocoagulation was performed in May and August, but it failed to relieve the pain. She underwent a surgical operation, but she was not enthusiastic about it.
The patient visited our clinic seeking to improve his symptoms.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 9 | 0 | 6 | 7 |
* Pain is rated as 5 on a daily basis, and 10 when pain is present.
No pain at all is rated as 0, and the maximum possible pain is rated as 10.
Main areas of pain and numbness: lower back, numbness in the right lower limb.
Bending forward: no change
Bending backward: aggravation of pain
Lasegue test: positive at 30 degrees on the right side
Point of tenderness: L3/4 on both sides, and 4/5 on both sides
Additional explanations on our clinic’s medical examination
・Daily activities
She must usually adopt a prolonged standing posture. Pain occurs when bending or twisting at the waist.
His walking ability is not affected.
Imaging and findings
- L2/3, 3/4, 4/5 – degeneration of the intervertebral discs
- L3/4 – disc herniation
- L4/5 – annulus fibrosus tear on the right side
The above findings were also observed on the imaging.
・L3/4 – disc herniation was observed and may be the main cause of pain in the lower back and numbness in the lower extremities.
・L4/5 – annulus fibrosus tear was also observed, and may also be one of the causes of the past symptoms, so treatment was recommended as a preventive measure.
Based on the examination and imaging findings, we proposed the above treatment.
Treatment
After consulting with the patient, the Cellgel Method was performed on L3/4 and 4/5.
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
