Lumbar Disc Replacement

	A new Restoration of Motion, Return to Sports, Return to Life.
	We work with all insurers Phone consultations offered with Dr. Pazmino for out of state, international, or distant patients.
Spine Cal Surgeries are completely performed by Board Certified Spine Surgeons. No residents, medical students or interns will ever perform or even be present during any portion of your procedure.
Spine Cal patients enjoy unlimited, instant contact with our Doctor and staff Long Doctor visits…you will not feel rushed during your appointment In Depth MRI review: This is unique to our practice, as Dr. Pazmino was once a 3rd grade teacher, he will ensure you will understand your films completely by the time you leave our office…This is a Spine Cal guarantee Cutting edge technology Ultra-fast recovery Concierge Medicine Satisfaction Results Quality
Stunning Technologys Disc arthroplasties have adopted crucial aspects from total joint arthroplasties of the hip and knee and adopted these for placement in the cervical and lumbar spine. The implant was developed using the clinically proven ball and socket concept used in joint replacement implants for over 40 years. The Prodisc-L implant is composed of three components – two cobalt chrome alloy (CoCrMo) endplates and an ultra-high molecular weight polyethylene (UHMWPE) inlay.
FDA Approved The ProDisc concept was developed in the late 1980’s by Dr. Thierry Marnay, a French orthopedic surgeon. In early 1990, Dr. Marnay and another surgeon started implanting a series of ProDisc implants in the lumbar spine.the predecessor of the ProDisc-L implant, was first implanted in 1990. Since 1999, over 16,000 ProDisc-L Total Disc Replacements have been implanted worldwide. The device was approved by the FDA for use in the United States in August 2006.
Ball and Socket Design Designed from the ground up this offers a Semi-constrained design which provides a fixed center of rotation. This allows for a controlled dynamic motion through the physiological range of motion. Furthermore this prevents pure translational motion to theoretically protect the facets from excessive shear loading.
Secure Fixation The patented central keel provide secure primary or initial fixation. The endplates are plasma sprayed with a titanium coating which promotes long term bony on-growth.
Modular implant components Different anatomical combinations facilitate accurate match with the patient’s anatomy 6 different footprints for Dr. Pazmino to choose from and customize your disc replacement: Medium, Large and Extra Large sizes with “deep options” (same width with 2 mm more in depth) 3 different heights: 5, 6 and 7 mm heights
Straightforward Operation in Experienced Hands Dr. Pazmino can perform this through his standard anterior cervical approach. This enables him clear visualization into the disc space. Through this procedure Dr. Pazmino limits distraction forces on surrounding anatomical structures.

Lumbar Artificial Disc Replacement / Arthroplasty

Devices are being developed for the lumbar spine to restore the function of all or part of the degenerative disc. By replacing a collapsed, faulty, painful degenerative disc with a mobile artificial disc replacement motion is restored and theoretically the risk for adjacent, or nearby disc degeneration can be decreased.

The renewed interest in Lumbar artificial disc replacement, or arthroplasty, has been in part stimulated by the desire for an effective alternative to lumbar fusion. The first artificial disc replacements performed were methyl-acrylic injections and Lucite ring models, which were first inserted in the mid-1950s. Over the past fifty eight years, advances in technology have provided for several generations of disc arthroplasties (Vitallium spheres in the late 1950s, silicone injections and prostheses in the 1970s). Orthopaedic surgeons have been performing hip, knee, shoulder, wrist, elbow and ankle replacements for several years. Dr. Pablo Pazmino has combined new developments in technology, with arthroplasty concepts and lessons gleaned from his Orthopaedic Arthoplasty experiences, to apply these to the spine.

Dr. Pablo Pazmino's Orthopaedic knowledge includes concepts such as modularity, revision surgery, kinematics, geometry, mechanics, bone-implant interfaces, impingement, wear properties, fixation techniques, porous-coated implants, ceramics, plasma-sprayed implants, and high-density polymer mobile bearing surfaces.

The image below demonstrates the concept of porosity and the importance of porous coating. Here is a close up view of the porous ongrowth surface which allows bone from the vertebral bodies to actually grow onto and bond with the endplates of the artificial disc.

The Prodisc-L arthroplasty consists of two metal (cobalt-chrome alloy) endplates that are anchored to the top and bottom surfaces of the spinal bones (vertebrae) through both keel fixation (The fins featured on the metal surfaces) and porous ongrowth (The pores on the metal). In between the endplates there is a plastic (ultra-high molecular weight polyethylene, or UHMWPE) inlay that fits between the two endplates. The plastic inlay and endplates help restore the natural distance between the two vertebrae (disc height). The top (superior) endplate can slide over the domed part of the inlay, which can allow movement at the level where it is implanted.

For each patient, Dr. Pablo Pazmino custom fits each arthroplasty to approximate the overall geometry of the disc's intended height, width, depth, and axial plane dimensions in order to create appropriate stability, and fit within the intended level, and preserve normal motion and load on the facet joints.

Once inserted the mechanics of the disc prosthesis must allow for normal load transmission through the disc without failure, abnormal motion, load transfer, or shifting to other structures such as the facets or nearby discs.

1. Eliminate the need for a fusion
2. Eliminate the need for bone grafts and donor-site morbidity
3. Minimize the stresses which occur on the adjacent level/the discs above and below the degenerated disc
4. Preserve motion of the spine
5. Restore shock-absorption capabilities of the disc itself
6. Restore disc-space height and indirectly restore foraminal size (where the nerve exits the spine)
7. Maintain stability of the spine
8. Help protect neural elements/nerves
9. Relieve back pain associated with degenerative disc disease
10. Provide an alternative option for patients with lumbar degenerative disc disease who have pain and have tried a full course of non operative management

1. SB CHARITÉ® Intervertebral Prosthesis
2. PRODISC®-L Total Disc Replacement

Several Lumbar Disc Arthroplasties are currently being developed and we are in the process of evaluating a third generation Lumbar arthroplasty.

1. Severe Radiculopathy
2. Osteoporosis
3. Spondylolisthesis
4. Spinal stenosis
5. Facet joint arthritis
6. Significant psychiatric problems
7. Scoliosis
8. Spinal tumor
9. Infection
10. Arachnoiditis

The Food and Drug Administration (FDA) has approved the Prodisc-L for the lumbar spine in treating pain associated with degenerative disc disease. The lumbar devices were approved for use in the lumbar spine for patients who have had no relief from low back pain after several months of non-surgical treatment. Dr. Pablo Pazmino currently uses the Prodisc-L prosthesis, and is currently investigating other third generation Lumbar Arthroplasties as part of ongoing clinical trials.

When Should You Seek Medical Care?

If severe pain occurs following an injury (motor vehicle accident, diving accident, or fall), a trained professional, such as a paramedic, should immobilize you to avoid the risk of further injury and possible paralysis. Emergent medical care should be sought immediately.

Immediate medical care should also be sought when an injury causes pain in the neck that radiates down the arms and legs.

Radiating pain, or numbness in your arms or legs which causes weakness in the arms or legs without significant neck pain should also be evaluated.

If there has not been an injury, you should seek a Spinal Evaluation with Dr. Pablo Pazmino when pain is:

1. Continuous and persistent
2. Severe
3. Accompanied by pain that radiates down the arms or legs
4. Accompanied by headaches
5. Accompanied by numbness, or tingling
6. Accompanied by weakness!

Many patients seek care for Lumbar Artificial Disc Replacement pain by Dr. Pablo Pazmino because as an Orthopaedic surgeon he is specifically trained to diagnose, treat, and help prevent problems involving the muscles, bones, joints, ligaments, and tendons. Although Dr. Pablo Pazmino confines his practices to Spinal pathology he also treats a wide variety of diseases, injuries, and other conditions, including Lumbar Fractures.