Patient Case Studies

Here is a patient with a prolonged history of severe back pain and leg numbness. He underwent a posterior laminectomy and posterior lumbar fusion at a nearby academic center. He had an opinion for a large posterior lumbar fusion with extension of hardware into his thoracic spine. He decided to see Dr. Pazmino for a second opinion. Dr. Pazmino offered him a lumbar revision surgery which included removing the prior hardware and decompressing all neural elements under compression from arthritic bone and overgrown ligamentous tissue.

In his own words...

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Dr. Pazmino & Patient

“Prior to surgery with Dr. Pazmino I could barely walk. I could not stand upright, I was hunched over and every week I was getting worse and worse. If I kept going in that direction I would barely be able to walk in a month or two. The surgery that was performed was a fusion a revision at level 3-4 and rods that were put on the back side that were curved so that allowed me to stand straighter. The surgery was a very long surgery because of the fact that I had no separation, no spaces between my vertebraes. Dr. Pazmino worked on me for about eight hours. He had to work extra hard to enable him to put a spacer in between my vertebrae so I’d have room for my nerves. The surgery, it has been 6 months since I’ve had the surgery. I can stand much straighter. I feel much, much better. There is no question my quality of life is better than it was before. I would highly recommend Dr. Pazmino. You don’t find Doctors like him that would explain everything to you, so that you completely understand, everything that he is going to do. The surgery I would recommend it and Dr Pazmino to anyone that I know that’s in need of back surgery and back problems. Hopefully I wont have to have any more surgeries but if I do he would be the only Doctor who would perform them.”

With this new technology, offered by Dr. Pazmino at Spinecal, this Nuvasive Brigade cage can be placed into a degenerated segment of the back to restore disc height and alignment. In fact if you notice his radiographs Dr. Pazmino made him a little bit taller with the procedure. This patient is now six months out from his surgery performed by Dr. Pazmino at Cedars Sinai Medical Center, and as you can tell from his testimonial he has already noticed complete relief of her back and leg pain. He has also noticed improved strength in his legs.

Dr. Pablo Pazmino is able to place the screws anteriorly through the cage. This was performed at two levels in this situation L4-5 and L5-S1.

This is the final construct as viewed from the front and from the side. Here you can see he has been completely straightened out from the front view and from the side view he has been made taller and using screws he now has had a curvature restored in his lumbar spine.

X-Rays After Surgery

These Nuvasvie brand spacers are an option and can be seen here. They are made of substance called PEEK (Poly Ether Ether Ketone) which feels like plastic. This material has properties which closely resemble our native bone. Dr. Pazmino places screws through the cages into the bone to hold them securely in position. Because these cages are made out of PEEK they are see through on Xrays and this allows Dr. Pazmino to closely follow the healing process which occurs inside the cages.

Bone and bmp is placed inside the cages to stimulate healing. There are several choices and material Dr. Pazmino can offer you to fill this cage. We can use local bone, transplanted bone from your hip or bone taken from a cadaver. This bone starts to heal within the cage and joins, or fuses, the bones above and below the spacer to each other. This process takes a year to complete. In three months this cage is filled with bone which is the consistency of cotton candy, in 6 months this bone is the consistency of Styrofoam, and by 12 months this bone inside the cage is strong like oak and normal bone. By 12 months the fusion process can be considered complete. In the meantime the screws through the cage keep the spacer in place. This is why Dr. Pazmino follows his patients at 3 weeks, 6 weeks, 3 months, 6 months and one year.