Column Treatment Case Report No. 67｜ ILC International Lumbago Clinic (Tokyo Clinic)
May 12, 2023
The case of a patient who failed to get better after surgical treatment of his disc herniation at another hospital.
The patient
A male patient in his 40s.
The patient’s medical history to date
More than 20 years ago, the patient developed numbness in the right lower limb due to disc herniation in 4/5, improving after undergoing a surgical operation.
After that, he had mild strained back episodes about 1 to 2 times a year.
In April 2023, he woke up in the morning and his left leg was numb. At first he could not walk, but although it improved after a few days, he decided to come to our clinic.
Symptoms before treatment
・Pain levels before treatment
| Lower back | Lower limbs | Numbness | Buttocks | |
|---|---|---|---|---|
| Pain level | 0 | 7 | 4 | 1 |
No pain at all is rated as 0, and the maximum possible pain is rated as 10.
Main areas of pain and numbness: left lower limb.
Bending forward: no change
Bending backward: pain in the buttock
Lasegue test: negative
Point of tenderness: none
Additional explanations on our clinic’s medical examination
・Daily activities
Symptoms aggravated when standing or walking.
The patient walking ability is limited to less than 100m.
Imaging and findings
- L3/4, 4/5, 5/s – disc degeneration
- L4/5 – disc herniation on the right side
- L5/s – spinal canal stenosis
The above findings were also observed on the imaging.
・L3/4 – disc degeneration with protrusion, indicated as a conservative treatment.
・L4/5 – disc herniation and foraminal stenosis in both intervertebral foramen, which is the probable cause of the pain and numbness.
・5/s – spinal canal stenosis and foraminal stenosis in both intervertebral foramen were observed, and may be the probable cause of the pain and numbness.
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, 4/5 and 5/s.
This is an image of the patient’s back after the Discogel injection.
The treatment took about 30 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
