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ILC's Treatment for Lumbar Compression Fracture

Having been adopted in over 54 countries globally,
the "Cellgel Method" for treating lower back pain
is now available in Japan

For those who have been told it was impossible to operate,
For those who have had recurrence of pain post-surgery,
A low-risk, outpatient treatment is now an option for you.

back pain image

Contents
Table of Contents icon Table of Contents

  1. 1 What is lumbar compression fracture?
  2. 2 Main symptoms of lumbar compression fracture
  3. 3 Causes of lumbar compression fracture
  4. 4 Why is the recurrence rate so high?
  5. 5 What are the effective treatments for lumbar compression fracture?
  6. 6 Treatment at ILC
  7. 7 FAQ about lumbar compression fracture and treatment

This page provides information on the main symptoms and causes of lumbar compression fracture and our treatment procedures. The information includes the method of treatment, treatment time, and information about insurance. We use the Cellgel method, which is one of the most advanced methods in the world, and the characteristics of this method are also described in detail.

Please read this page especially if you have been told that you cannot be cured without surgery, if you have had surgery in the past but have not improved, or if you got better after surgery but the symptoms have recurred.

What is lumbar compression fracture?

A compression fracture is the collapse of the vertebral body in the spine. If it occurs in the thoracic spine, it is a thoracic compression fracture; if it occurs in the lumbar spine, it is a lumbar compression fracture. Compression fractures occur at a rate of 10.8% in men and 22.2% in women in their 70s, with approximately 300,000 to 1 million new cases reported.

A lumbar compression fracture is a fracture caused by a vertical force. Characteristically, it is more common in postmenopausal women, and in the early stages, many complain of pain every time they move their bodies.

In younger people, fractures are rarely caused by minor external stresses, although they can be caused by strong impacts such as falls from heights or traffic accidents. As people get older, they are more likely to develop osteoporosis (brittle bones), a condition in which bone strength decreases. As osteoporosis progresses, lumbar compression fractures may occur when the body is unable to bear the weight of the body due to buttocks or normal daily activities (twisting at the waist, carrying heavy objects, etc.).

As stated by the Orthopaedic Society, a person who has had one fracture of the spine is four times more likely to have a new spinal fracture. Femoral neck fractures (fracture of the bone at the base of the thigh) are also known to be almost twice as likely to occur.

The key to healing a lumbar vertebra compression fracture is how well the fracture site is kept at rest.
Immediately after the injury, the fracture site is extremely unstable, and as shown in the radiograph below, vertebral deformity can develop.
Progressive vertebral deformity can lead to prolonged pain and a loss of alignment of the spine itself.
*Reference for image: Research Article "Treatment of Osteoporotic Lumbar Compression Fractures" (https://www.jstage.jst.go.jp/article/jcns/25/9/25_718/_pdf)

腰椎圧迫骨折のレントゲン

Main symptoms of lumbar compression fracture

The main symptom of a lumbar compression fracture is localized lumbar pain. If the fracture is complicated by the condition of the fracture or spinal canal stenosis, it may be accompanied by nerve-related problems such as leg pain and numbness.

The intensity of symptoms varies greatly from person to person, with some patients experiencing pain so severe that they cannot walk and others experiencing only a mild dull ache.
Chronic pain may vary daily in terms of intensity, but if the pain is severe, the patient may not be able to turn over in bed or move the body from a sleeping position to a sitting position.

If the patient continues to forcibly move the body to avoid pain, or to keep the fracture in a posture that compresses the fracture, the fracture will worsen and the pain will be prolonged.

The vertebral body (spine) that has been fractured by a compression fracture will not return to its original state, and the bones will fuse in a deformed state, leading to:

  • i. Chronic lower back pain
  • ii. Spinal kyphosis (hunched back, making it difficult to straighten the spine)
  • iii. Higher likelihood of falls due to poor posture
  • iv. Decline in overal quality of life

If you have any of these symptoms, we recommend that have it checked as soon as possible.

Causes of lumbar compression fracture

Lumbar compression fractures may be caused by:

  • 1. Osteoporosis: Bone density decreases and the vertebrae cannot withstand the compression force, resulting in a fracture.
  • 2. Trauma: Lumbar compression fracture is caused by a strong external impact to the vertebrae due to a fall or traffic accident.
  • 3. Pathological fracture: The strength of the vertebrae is reduced due to bone tumors, etc., and the vertebrae become vulnerable to fracture.
Image of lumbar compression fracture

Why is the recurrence rate so high?

Once a lumbar compression fracture is sustained, the incidence of compression fractures of other vertebrae is said to increase. It has been reported that the probability of a compression fracture in one vertebra is 2.4 times higher than that of a person without a compression fracture in the five years following the injury, and 4.9 times higher if there are two or more compression fractures.

This is due to the fact that once a compression fracture is sustained, the standing posture becomes hunched, and when the back becomes rounded, the center of gravity is displaced forward. As the center of gravity moves forward, the spine continues to experience compressive forces, triggering compression fractures in other vertebrae.

correct posture
hunchback

In addition, once a compression fracture of the spine occurs, the intervertebral discs above and below the fractured bone can degenerate, leading to herniated discs and spinal canal stenosis. The images below are actual patient cases reported in the paper.

Degeneration of the intervertebral discs increases the risk of not only herniated discs and spinal canal stenosis, but also changes in posture and muscle use that can lead to a variety of other problems, such as those listed in our list of spinal diseases.

Lumbar compression fracture X-ray

Image Reference: Thesis titled "A retrospective study evaluating the correlation between the severity of intervertebral disc injury and the anteroposteriortype of thoracolumbar vertebral fractures"

What are the effective treatments for lumbar compression fracture?

The first step in treating a lumbar compression fracture is to rest as much as possible and follow the doctor's instructions to prevent deformation of the fracture site. It is important to rest until the doctor's diagnosis and approval is given, as there is a risk of bone deformation if the pain subsides and the patient decides to move or play sports.

If the pain persists after treatment is completed, or if the pain recurs or symptoms of numbness appear after the pain has improved, it may be due to disc degeneration or spinal stenosis, and an MRI scan is recommended to check for abnormalities. If conditions such as disc degeneration are confirmed, conservative treatment may help in some cases, but if the pain persists and does not get better, surgery or treatment at our clinic is the next step.

Conventional surgical procedures often include discectomy for herniated discs and surgical procedures to reduce pressure on nerves for conditions such as spinal stenosis. Among the surgical methods, spinal fusion involves removing muscles and ligaments and immobilizing unstable bones, or using an endoscope to shave some lumbar vertebrae and remove thickened ligaments to remove pressure. These conventional surgical methods cannot repair disc damage that has been caused by a compression fracture, so degeneration and herniation may recur even after surgery.

Therefore, we believe that if we can control the degeneration of the intervertebral disc, we can prevent inflammation related to nerve compression, such as bone deformation and thickening of the ligaments. Our disc repair treatment using the Cellgel method restores disc function by repairing the torn annulus fribrosus and replenishing the water content of the nucleus pulposus inside.
The treatment can be performed as a one-day procedure. Local anesthesia is given to the lower back, a needle is inserted into the disc, and a chemical solution is injected.
It takes about 25 minutes and patients can go home after resting for about an hour.

Conventional Surgery

Treatment image of the cell-gel method Treatment image of the cell-gel method

The removal of the bone and part of the disc that is compressing the spinal canal relieves pressure on the spinal canal, but the spine becomes unstable, so an artificial disc is inserted and the bone is secured with a metal device called a bolt and rod.

Cellgel Method

Treatment image of the cell-gel method Treatment image of the cell-gel method

Since many of our patients come from far away,
we are happy to give free consultations to see which treatment is best for you

We'll diagnose your MRI images for free！

Free Diagnosic Imagingeast

Treatment at ILC

There are four main treatments at our clinic.

As mentioned above, the root cause of each back pain disease is "inflammation and deformation due to aging of the intervertebral discs." Although the four treatment methods have different features and advantages, we would like to first introduce the "Cellgel method," which is the only one capable of intervertebral disc repair.

01

The Cellgel Method

About Cellgel

The Cellgel method is an advanced treatment for low back pain that has been implemented in more than 54 countries worldwide, predominantly in Europe.
As with other treatments, it does not decrease the disc volume, and since the drug remains in the disc as a gel-like implant after treatment, the disc can be preserved. Recent studies have also shown that the volume of the disc increases after treatment.*1
It is also thought that by repairing the disc and preventing leakage of the Nucleus Pulposus, the disc itself will restore its normal function with its own regenerative ability (*2).
It is particularly recommended for patients who are concerned about the risk of conventional disc surgery (MED, PELD, etc.).

*1 Source: European Journal of Radiology 109 (2018) 101–107 , Efficiency of an ethyl alcohol gel in symptomatic disc hernation
*2 Source: International Journal of Spine Surgery Vol. 15 Appendix 1 from regenerative treatment of disc degeneration

Certification
*Medical institutions are required to have certifications like this one to perform the "Cellgel method".
"Very good or good results were obtained in 202 (91.4%) of the 221 patients in group A. Of the 44 patients in group B, 37 patients (84%) presented very good or good results and in 9 (82%) of the 11 patients of group C, we obtained similar results. There was no allergic complication in any of our patients. Long-term follow-up magnetic resonance showed a dramatic reduction in hernia volume."

- Dr. J. Theron, one of the world's leading experts in the treatment of Celgel method, from his research article "Percutaneous Treatment of Lumbar Intervertebral Disk Hernias With Radiopaque Gelified Ethanol - A preliminary study."

Merits of Cellgel

Flow Cellgel Treatment Process

Price Cost of Treatment for the Cellgel Method

Number of
Discs Treated		 1 disc 2 discs 3 discs 4 discs 5 discs
Treatment Cost 1,320,000 JPY 1,430,000 JPY 1,540,000 JPY 1,650,000 JPY 1,760,000 JPY

Swipe left/righ

* The cost of treatment is indicated including taxes.
*If treatment is performed at our clinic, all examination/diagnosis costs and test costs such as MRI are included in the above costs.
*This treatment method is not covered by Japanese health insurance, so you will have to pay for the entire treatment yourself.
*Payment by credit card (VISA, MasterCard, JCB, American Express, Diners, Discover) is also possible.
*If you would like rehabilitation (low back pain specialized rehabilitation), it is also possible to pay by bank transfer.
*If you live and work in Japan, you can receive a tax refund by filing your final medical expense return.

Click here for other treatments available at our clinic

FAQ FAQ about facet joint syndrome and treatment

Q
What's the difference in the reccurence rate between Cellgel and conventional surgery?
A

Surgical procedures, which began in the 1960s, aimed to remove and sometimes fix deformed bones and herniated tissue. However, new bone damage caused by screws and the lack of fundamental treatment (repair of the intervertebral disc annulus fibrosus) resulted in the appearance of additional back pain and recurrence rates.

Therefore, in the 1980s, the need for fundamental treatment increased, and the intervertebral disc treatment (Cellgel) that we provide at our clinic began. Cellgel, in particular, have been proven to repair and regenerate the intervertebral disc, resulting in not only improvement of symptoms, but also an extremely low recurrence rate.

Q
How is the disc to be treated determined?
A
The doctor will spend about 30 minutes with the patient while looking at the MRI and X-ray images to determine the cause of the condition, determine the treatment area, and explain the corresponding treatment method to the patient. MRI images show the main factors that contribute to back pain (disc, nerve, ligament, and joint), such as changes in shape, pressure on the nerve, presence or absence of damage, and inflammation. The x-ray image mainly confirms the condition of the bones.
Q
Why is the Cellgel method applicable to cases where surgery showed no improvement?
A
During surgery for disc herniation, the prolapsed herniation is removed, but the damaged disc remains intact. As a result, fresh nucleus pulposus components leak from the damaged disc and inflammation persists. On the other hand, our treatment can treat the disc injury itself, thus suppressing inflammation by reducing the fresh leakage of nucleus pulposus components.
Q
My back pain may temporarily worsen after treatment. How long will it last?
A
The reason for the lower back pain is that spinal ligaments that have been compressed are stretched; the lower back pain lasts for about two weeks and then subsides.
Q
What level of exercise can I perform after treatment?
A
General recreational exercise and sports can be done without any problem. For professional athletes, the possibility of new disc damage is high and should be discussed in consultation with a doctor.
Q
Please tell me about what I should be cautious about after treatment.
A
During the first few days after treatment, the patient should rest and avoid prolonged sitting, heavy lifting, twisting, bending, or strenuous exercise. Patients should be able to perform routine tasks one week after treatment and should be able to perform light exercise by the second week. Weight training is allowed after 3 months.
Q
Is the treatment covered by the Japanese national health insurance?
A
No, it is not covered by the national insurance. If you have life insurance, you may be eligible. Please feel free to consult our staff regarding this matter.
Q
How long must I wait to be able to walk after treatment?
A
It is an outpatient/day treatment, so you can walk about an hour after the surgery.
Q
How many doctor visits do I need to make before treatment?
A
We require an MRI to be taken within three months for remote diagnosis, either with our affiliated clinic or from data sent by you. You can receive treatment on the same day after phyiscal diagnosis. You may also request only the diagnosis and come back only for the treatment at a later date.
Q
Can I fly immediately after the treatment?
A
If there are no problems after the treatment, you may fly. If there is any pain after the treatment, flying may not be recommended depending on the doctor's evaluation.
Q
What should I be cautious of when I am diagnosed with a lumbar compression fracture?
A
Once you have been diagnosed with a lumbar compression fracture, the first step is to prevent further disc and bone degeneration. If you perform a lot of back-straining activities or tasks, reduce the frequency of such movements, and listen carefully to your doctor's advice to determine what you should do next.
Q
Can a lumbar compression fracture be cured without surgery?
A

In principle, with rest, the bone will repair itself and heal. However, if the bone is deformed during the repair process, the bone itself may compress the spinal nerves or the intervertebral discs above and below the bone may degenerate due to the deformation of the bone.

In such cases, conservative treatment is the first step, but if the symptoms persist and do not get better, surgery or our treatment may be necessary. If the pain and numbness have become chronic, we recommend an MRI scan and careful medical examination to accurately diagnose any abnormalities before surgery.

Q
Are there medications to cure a lumbar compression fracture?
A

Medication will not fundamentally cure the disease.

However, medications may be prescribed to relieve pain and improve blood flow. For severe pain, it may be necessary to take painkillers. Patients who have been taking medication for a long time may experience other pain and side effects if the medication is abruptly stopped.

Q
Can I continue working if I have a lumbar compression fracture?
A

It is possible to continue, depending on the severity of the symptoms.
However, if your job involves a lot of desk work or heavy labor, you need to refrain from such work as much as possible, as it is hard on the lower back.
If it is difficult to change your work environment, consider improving your physical condition, posture, and muscle strength. If these methods improve the condition, we recommend that you continue to use them.

If there is no improvement, we recommend that you consult a doctor and receive a diagnosis.

ILC Rehabilitation X Lumbar Compression Fracture Treatment

Although the Cellgel method can repair and regenerate the disc itself, and other treatment methods we offer can fundamentally heal the disc; it is possible that the cause of back pain is not only the disc, but also muscles, joints, and ligaments that are affected by the disc.

In cooperation with our rehabilitation specialists, we recommend treating back pain caused by muscles, joints, and ligaments together.

We also offer a short-term intensive program for patients who live far away or overseas.

  • 01

    ILC's Specialized Back Pain Rehabilitation

    Our Rehabilitation Approach to Lumbar Compression Fracture

    A compression fracture of the lumbar spine, once damaged, can cause the spine to become misaligned and stress is more likely to be applied to both the fractured site and other unrelated areas. It is common for patients to suffer compression fractures in other areas of the body, or to have poor posture, which puts stress on the intervertebral discs and back muscles, causing disc degeneration and back pain. Although it is difficult for rehabilitation to restore a fractured site to its original state, rehabilitation for prevention of possible back pain, disc degeneration, and osteoarthritis of the hip is extremely important.

    In this rehabilitation program, we intend to improve the reduced quality of daily life activities through the easing of symptoms and pain with exercise and acupuncture therapy, as well as prevent recurrence and other conditions. In addition, since nutrition is also a contributing factor to brittle bones, dietary therapy by a dietitian is also provided at the same time.

    normal and curved spine
  • 02

    ILC's Specialized Back Pain Rehabilitation

    How to Evaluate Lumbar Compression Fracture

    In order to understand the state of the compression fracture, a consultation is held with the doctor to determine the damaged site and shape based on imaging findings, and to determine the area under stress.

    Using the findings as a reference, we will evaluate the aggravating and mitigating factors of the symptoms in the posture and movements of daily life while actually moving the body slowly.

    Aggravating factors are defined as movements that should not be performed, and mitigating factors are symptoms that can be alleviated by doing certain body movements. We will comphehensively evaluate these factors with muscle strength and stiffness, and explore the nature of the symptoms.

    If necessary, a Spinal Mouse is used to evaluate the condition of the vertebrae caused by changes in posture.

  • 03

    ILC's Specialized Back Pain Rehabilitation

    Rehabilitation Treatment for Lumbar Compression Fracture

    Rehabilitation of lumbar compression fractures can be divided into two main periods: during the period of external fixation and after the bones have fused/healed.

    1. External Fixation Period
      • i. Promote acceleration of bone healing
        • Thermal therapy
        • Acupuncture
      • ii. Prevention of kyphosis
        • Activation of inner muscles to maintain the natural S-curve of the spine
        • Learning deep muscle movements (diaphragm and pelvic floor muscle group, multifidus and transversus abdominis muscles)
        • Acupuncture (electro-acupuncture) treatment to prevent muscle contracture and blood flow obstruction
        • Review of breathing techniques
      • iii. Lower limb strength training
    2. After Bone Fusion (with kyphosis)
      • i. Relief of lumbar back pain
      • ii. Prevention of further spinal deformity
        • Relaxation of the muscular tension of the longissimus lumborum and iliocostal muscles fo pain relief
        • - Strength training of back muscle groups, rectus abdominis and oblique abdominal muscles
        • Activation of multifidus muscles
      • iii. Lower limb strength training

    Rehabilitation is designed to prevent lumbar back pain from becoming chronic and lowering one's quality of life.

    blood improvement diagram
    Illustration of trunk training
  • 04

    ILC's Specialized Back Pain Rehabilitation

    Treatment Period for Lumbar Compression Fracture

    Treatment of lumbar compression fractures varies according to the doctor's opinion, but generally involves four weeks of a torso cast followed by a rigid corset for approximately eight weeks.
    There is no end to the rehabilitation period, and the patient is encouraged to continue strength training while relieving pain in the lumbar back.
    Since the degree of compression fracture may cause lumbar kyphosis, interruption of exercise and self-care based on your own judgment may progressively worsen your condition.
    Long-term and sustained self-care is necessary.

We aim to achieve 100% effectiveness of treatment while incorporating the latest technology, so we spend at least 30 minutes with each patient to carefully and meticulously examine the patient's concerns in order to make a proper diagnosis and propose the most suitable treatment methods.

We are certain to find a way to alleviate or eliminate the pain and numbness you are experiencing, so please do not give up and give us a call instead!

- Tadaaki Minowa, Clinic Director

Dr image
WhatsApp Reception +81-90-4202-1624 Hours：9:00-17:00 Except Sundays