Dr. Pazmino performs a TLIF procedure to alleviate pain from degenerative disc disease by removing the damaged disc and using a bone graft and spacer to achieve fusion between vertebrae. The surgery involves small incisions, removal of degenerated discs, and insertion of pedicle screws to immobilize painful segments, ultimately decreasing pain. Patients are encouraged to seek consultations through provided online resources or by calling a toll-free number.

2. Orthopaedic Surgery American Academy of Orthopaedic Surgeons Clinical Faculty Olympia Medical Center Cedars Sinai Medical Center Century City Doctors Hospital Education The University of California, Los Angeles The University of Michigan, Ann Arbor

3. For patients with back pain or leg pain which is caused by degenerative disc disease the TLIF may be an option With this procedure Dr. Pazmino is able to eliminate motion between painful vertebral bodies by using a bone graft material Concept: By eliminating painful motion, pain is removed

4. First Dr Pazmino fashions one small incision over the lumbar spine

5. Here you can see the degenerated disc and the small herniation protruding backwards from the disc

7. Part of the bone needs to be removed during surgery by Dr Pazmino in order to remove the degenerated discs Dr Pazmino is then able to remove all the degenerated disc through one of these tiny bony windows

8. Here you can see the Damaged Lumbar Disc which is causing all the pain

9. Here you can see the disc has been completely removed by Dr Pazmino. Some of the outer disc wall is maintained to keep the spacers in place.

10. In order to create a fusion, Dr Pazmino next inserts a spacer where the disc was removed

11. Next the Bone Graft is carefully adjusted to lie centrally within the disc space

12. Final central positioning of the bone graft spacer This bone graft spacer 1)Realigns the vertebral bones 2)The spacer also lifts pressure from the pinched nerve roots.

13. Next Dr Pazmino places pedicle screws into the vertebral bodies above and below the vertebral bodies

14. Rods are next placed into the screws to immobilize the painful vertebral segments

15. Bone forms along the rods and bones laterally and this creates the final ‘fusion construct.’ This immobilization removes the painful segment and therefore decreases pain

17. Thank you for your time. If you know someone who could benefit from a consultation for a TLIF, please refer them to our online website or call toll free to schedule an appointment 1-8SPINECAL-1 www.beverlyspine.com www.santamoincaspine.com