Page 2 - Laminoplasty

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What does the condition feel like?
The most common complaint in patients is a dull ache in
lower back and buttock areas. This is actually a mechanical
pain which is caused by the vertebrae slipping forward on
the level below, which causes wear and tear on the disc
and joints of the spine.
Pain is usually worse with standing, walking, or bending
backwards. In the early stages of this condition pain may be
eased by resting or bending forwards, leaning on furniture
or on a shopping cart. After this condition has been around
for a while no positions relieve the pain.
Muscle spasms are also common in the lower back.
Why do I have leg pain?
Nerve pressure can feel like a pain that starts in the lower
back and runs down the legs. This pain can be along the
outer part and sides of the legs, along the groin, or along
the buttocks and back of the thighs and calves. The pain
can be sharp or be a numbness or tingling sensation.
How does it happen?
In a few cases it presents at birth, or during childhood as a
result of an injury. In adults, breakdown and degeneration
of the discs and facet joints can lead to spondylolisthesis.
Degeneration in the disc and facet joints of the spine cause
the vertebrae to move more than they should. The disc
weakens and presses the facet joints together. Eventually
the support from the facet joints becomes ineffective and
the top vertebrae slides forward.
In some instances a trauma can lead to a fracture in the
bony ring which then leads to slippage of one bone.
Because of the fracture of the bony ring the facet joints are
no longer able to provide a buttress allowing the vertebrae
with the crack in it to slip forward.
Diagnosis begins with a com-
plete history and physical exam
by Dr Pazmiño. He will need
to know specifically where the
pain spreads and what type of
pain you are feeling.
Dr Pazmiño will order and per-
sonally review Xrays and MRIs
with you. Dr Pazmiño was a
third grade homeroom teacher
prior to becoming a physician
and he truly enjoys educating
his patients. He will review
your studies and your condition
until you feel comfortable with
All questions will be
answered in detail.
How is it treated?
Some people get relief from symptoms without
Rest, cold and heat..
Dr Pazmiño may prescribe a short
period of rest or a muscle relaxant.
In certain cases Dr.
Pazmino may recommend cold compresses or ice which
can be applied several times a day for pain relief. After
spasms settle, Dr Pazmiño may recommend gentle heat in
some instances to relieve further symptoms.
Physical therapy, Acupuncture, Chiropractic pro-
In certain situations Dr Pazmiño may recommend
a course of physical therapy. He may design a custom tai-
lored course of exercises which can strengthen your lower
back and abdominal muscles. Dr Pazmiño may recom-
mend a particular physical therapist,acupuncturist, reflex-
ologist, or chiropractor who can then apply traction which
helps relieve pain for certain herniations, or subluxations..
If your symptoms persist Dr. Pazmiño may request
further imaging , procedures, and possibly surgery.
Epidural steroid injection.
Dr Pazmiño may
recommend an epidural where steroids are injected near
the nerves of your neck or back to reduce local
inflammation. In certain cases these are very effective in
relieving symptoms.
Lumbar Decompression.
This is the most common
procedure for spondylolisthesis. Decompression involves
removing all parts of the anatomy which are placing
pressure on the nearby neural elements. The excess
bone spurs,thickened ligaments, and disc herniations are
removed. This removes all pressure on the spinal nerves.
Next the amount of instability is assessed and may need
to be stabilized through a fusion. This procedure has
provided excellent results in thousands of patients with
intractable pain and is actually a very common procedure
performed by Dr Pazmiño weekly. For more information
on this procedure please look us up online on our website
www. spinecal .com
How does Dr. Pazmiño diagnosis this?