Dr. Peyman Pakzaban, MD

Dr. Peyman Pakzaban Neurosurgeon

Dr. Peyman Pakzaban is a board-certified neurosurgeon providing surgical assessment and treatment for conditions affecting the brain, spine, spinal cord, and peripheral nerves.

His clinical work includes minimally invasive spine surgery, microsurgical spine procedures, brain and pituitary tumour care, spinal decompression, spinal fusion, and treatment of selected nerve-compression conditions.

Dr. Pakzaban practises in Pasadena, Texas, and has worked in private neurosurgical practice since 1996. He is affiliated with HCA Houston Healthcare Southeast and sees patients who may need a first surgical opinion, another opinion after previous treatment, or continuing care following neurosurgery.

Patients may visit him for back pain, neck pain, arm or leg symptoms, spinal stenosis, herniated discs, weakness, difficulty walking, brain tumours, pituitary conditions, or another neurological problem that may require surgical assessment.

Patients comparing Houston-area spine specialists may also read about Dr. Daniel H. Kim’s neurosurgical and spine care.

Doctor Information

Name: Dr. Peyman Pakzaban, MD, FAANS
Specialty: Neurological Surgery
Board Certification: American Board of Neurological Surgery
Undergraduate Education: Massachusetts Institute of Technology
Undergraduate Degrees: Bachelor of Science in Chemical Engineering and Bachelor of Science in Biology
Medical School: Baylor College of Medicine
Medical Degree Completed: 1989
Medical School Distinction: Graduated with highest honors
General Surgery Internship: Massachusetts General Hospital
Internship Period: 1989 to 1990
Neurosurgery Residency: Massachusetts General Hospital and Harvard Medical School
Residency Period: 1990 to 1995
Chief Residency: Neurosurgery, Massachusetts General Hospital
Chief Residency Period: 1995 to 1996
Research Fellowship: Neurobiology and neuroregeneration through the Harvard Program in Neuroscience
Private Practice: Neurosurgery practice established in 1996
Primary Location: Pasadena, Texas
Hospital Affiliation: HCA Houston Healthcare Southeast
NPI Number: 1174523872
Language Consistently Listed: English
Accepting New Patients: Current availability should be confirmed directly with the practice
Telemedicine: Current availability should be confirmed with the office

About Dr. Peyman Pakzaban

Dr. Pakzaban completed undergraduate education at the Massachusetts Institute of Technology, earning degrees in chemical engineering and biology.

He then attended Baylor College of Medicine, where he earned his medical degree in 1989 and graduated with highest honors.

His postgraduate training began with a general surgery internship at Massachusetts General Hospital.

Dr. Pakzaban remained at Massachusetts General Hospital for neurological surgery residency training through Harvard Medical School. He later served as chief resident in neurosurgery.

During his training, he also completed research work in neurobiology and neuroregeneration through the Harvard Program in Neuroscience.

Neurological surgery involves the diagnosis and surgical treatment of conditions affecting:

• The brain
• The spinal cord
• The bones and discs of the spine
• Spinal nerve roots
• Peripheral nerves
• Related blood vessels
• Supporting neurological structures

A neurosurgical consultation does not automatically mean an operation is required. Dr. Pakzaban may review whether symptoms are likely to improve through observation, medicine, physical therapy, injections, or another non-surgical option before considering surgery.

Neurosurgical Conditions Evaluated

Dr. Pakzaban may evaluate and treat conditions such as:

• Herniated cervical and lumbar discs
• Spinal stenosis
• Cervical myelopathy
• Lumbar radiculopathy
• Cervical radiculopathy
• Degenerative disc disease
• Spondylolisthesis
• Spinal instability
• Spinal cord compression
• Brain tumours
• Pituitary tumours
• Spinal tumours
• Peripheral nerve compression
• Carpal tunnel syndrome
• Ulnar nerve compression
• Hydrocephalus
• Selected cerebrovascular conditions
• Neurological symptoms after previous spine surgery
• Back or neck pain associated with structural disease

The appropriate treatment depends on symptoms, neurological examination, imaging, medical history, and how strongly the condition affects movement or daily independence.

Neurosurgical Consultation

A consultation may include:

• Reviewing the main symptoms
• Discussing when symptoms began
• Completing a neurological examination
• Reviewing MRI or CT images
• Examining previous surgical reports
• Comparing current and earlier imaging
• Reviewing physical therapy and injection results
• Assessing medical risks
• Discussing surgical and non-surgical options
• Explaining expected recovery

Patients should bring actual imaging files when possible, not only the written radiology report.

The images allow Dr. Pakzaban to compare the location of structural changes with the patient’s symptoms and examination findings.

Minimally Invasive Spine Surgery

Minimally invasive spine surgery uses smaller surgical pathways and specialised instruments to reach the affected area while limiting disruption to surrounding muscles and tissues.

Depending on the diagnosis, potential advantages may include:

• Smaller incisions
• Less tissue disruption
• Reduced postoperative discomfort
• Shorter hospitalisation
• Earlier movement
• Faster return to selected activities

These benefits are not guaranteed for every patient.

Open surgery may be safer when the condition is extensive, anatomy is complex, a tumour requires broad access, or previous surgery has created significant scar tissue.

The most appropriate approach should be based on safety and the ability to treat the underlying problem properly.

Microsurgical Techniques

Microsurgery uses magnification, specialised lighting, and fine instruments to work around delicate nerves and blood vessels.

In spine surgery, microsurgical methods may help Dr. Pakzaban remove tissue pressing on a nerve while preserving surrounding structures.

Microsurgery may be used during selected procedures involving:

• Herniated discs
• Spinal stenosis
• Nerve-root compression
• Brain tumours
• Pituitary tumours
• Peripheral nerve conditions

The procedure used depends on the location and type of disease rather than the size of the incision alone.

Lower-Back Pain

Lower-back pain can arise from several structures.

Possible causes include:

• Muscle strain
• Disc degeneration
• Herniated disc
• Spinal stenosis
• Arthritis
• Spondylolisthesis
• Spinal instability
• Nerve compression
• Hip or sacroiliac joint conditions

Dr. Pakzaban may ask:

• When the pain began
• Whether an injury occurred
• Whether pain travels into a leg
• Whether numbness or weakness is present
• Which movements worsen symptoms
• How long the patient can stand or walk
• Which treatments have already been tried
• Whether bowel or bladder function has changed

Most episodes of lower-back pain do not require surgery.

A neurosurgical opinion may become appropriate when symptoms continue despite suitable care or when imaging and examination show significant nerve or spinal cord compression.

Herniated Lumbar Disc

A lumbar disc sits between the bones of the lower spine and helps absorb pressure.

A herniated disc occurs when part of the disc material moves beyond its usual boundary and irritates or compresses a nearby nerve.

Possible symptoms include:

• Lower-back pain
• Buttock pain
• Pain travelling down one leg
• Tingling
• Numbness
• Foot or leg weakness
• Pain made worse by sitting, bending, or coughing

Many patients improve through time, medicine, activity adjustment, or physical therapy.

Surgery may be considered when pain remains severe, neurological weakness develops, or the compressed nerve is unlikely to recover adequately without treatment.

Lumbar Microdiscectomy

Microdiscectomy removes the portion of a herniated disc pressing on a spinal nerve.

The procedure is performed through a focused surgical opening using magnification.

The goal is to relieve nerve compression rather than remove the entire disc.

Microdiscectomy may be considered when:

• Leg pain remains severe
• Conservative treatment has not provided enough improvement
• Imaging matches the symptom pattern
• Weakness is present
• The nerve remains significantly compressed

Back discomfort may not improve to the same degree as leg pain because several spinal structures can contribute to lower-back symptoms.

Sciatica

Sciatica describes symptoms following the pathway of the sciatic nerve or its spinal nerve roots.

Patients may experience:

• Sharp leg pain
• Burning
• Electric sensations
• Tingling
• Numbness
• Weakness
• Symptoms extending into the foot

Possible causes include a herniated disc, spinal stenosis, arthritis, or spondylolisthesis.

Dr. Pakzaban may compare the symptom pattern with strength, reflexes, sensation, and MRI findings.

Treatment should address the confirmed cause rather than the word sciatica alone.

Lumbar Spinal Stenosis

Lumbar spinal stenosis is narrowing around the nerves in the lower spine.

Symptoms may include:

• Leg pain while walking
• Leg heaviness
• Numbness
• Weakness
• Reduced walking distance
• Relief while sitting
• Improvement while leaning forward

The narrowing may result from enlarged joints, thickened ligaments, disc changes, or movement between spinal bones.

Treatment may begin with medicine, physical therapy, activity adjustment, or injections.

Surgical decompression may be considered when walking and daily function remain substantially limited.

Lumbar Decompression

Lumbar decompression creates more space around compressed spinal nerves.

Depending on the anatomy, the operation may involve removing part of:

• A spinal bone
• A thickened ligament
• An enlarged joint
• Herniated disc material

The amount of tissue removed should be sufficient to release the nerve while preserving stability whenever possible.

Some patients need decompression alone. Others also require fusion when the spine is unstable or when adequate decompression would create instability.

Spondylolisthesis

Spondylolisthesis occurs when one spinal bone moves forward relative to the bone below it.

It may result from:

• Degenerative changes
• A stress-related defect
• Congenital anatomy
• Trauma
• Earlier surgery

Possible symptoms include:

• Lower-back pain
• Leg pain
• Numbness
• Weakness
• Difficulty standing
• Reduced walking tolerance

Dr. Pakzaban may use standing X-rays, bending X-rays, CT, or MRI to assess alignment, movement, and nerve compression.

Treatment depends on the degree of movement, symptoms, stability, and response to conservative care.

Spinal Fusion

Spinal fusion joins selected spinal bones to reduce painful or unsafe movement.

It may be considered for:

• Spinal instability
• Spondylolisthesis
• Deformity
• Selected recurrent disc problems
• Severe degenerative disease
• Conditions requiring extensive decompression
• Certain fractures or tumours

Fusion may involve bone graft, screws, rods, cages, or other implants.

The operation should have a clear structural purpose. Fusion is not automatically required for every herniated disc or case of back pain.

Dr. Pakzaban may discuss why fusion is being considered, which levels are involved, and how it may affect movement and recovery.

Transforaminal Lumbar Interbody Fusion

Transforaminal lumbar interbody fusion, commonly called TLIF, is a procedure used to stabilise selected areas of the lower spine.

The operation may involve:

• Removing pressure from a nerve
• Removing part of a damaged disc
• Placing an implant in the disc space
• Adding bone-graft material
• Stabilising the spine with screws and rods

Dr. Pakzaban has professional experience involving minimally invasive and mini-open TLIF techniques.

The operation may be considered for instability, spondylolisthesis, recurrent nerve compression, or another condition requiring both decompression and stabilisation.

Neck Pain

Neck pain may arise from:

• Muscle strain
• Disc degeneration
• Arthritis
• Herniated discs
• Spinal stenosis
• Nerve compression
• Spinal cord compression
• Previous injury

Symptoms may remain in the neck or extend into the shoulder, arm, or hand.

Dr. Pakzaban may assess:

• Neck movement
• Arm strength
• Reflexes
• Hand sensation
• Coordination
• Walking
• Fine motor control
• MRI findings

Surgery is generally considered when a specific structural problem is responsible for neurological symptoms or when pain has not improved through appropriate non-surgical treatment.

Cervical Radiculopathy

Cervical radiculopathy develops when a nerve root in the neck becomes irritated or compressed.

Possible symptoms include:

• Neck pain
• Shoulder-blade discomfort
• Pain travelling down an arm
• Hand tingling
• Finger numbness
• Arm or hand weakness
• Changes in reflexes

Possible causes include a herniated disc, bone spur, or narrowing around the nerve.

Treatment may include medicine, physical therapy, injections, or surgery.

A surgical procedure may be considered when symptoms remain disabling or when weakness or nerve damage is progressing.

Cervical Myelopathy

Cervical myelopathy occurs when the spinal cord is compressed in the neck.

Possible symptoms include:

• Hand clumsiness
• Difficulty with buttons or handwriting
• Arm or leg weakness
• Balance problems
• Walking difficulty
• Leg stiffness
• Numbness
• Loss of coordination

Spinal cord compression may progress gradually and can sometimes cause permanent neurological impairment.

Dr. Pakzaban may compare MRI findings with walking, reflexes, strength, and hand coordination.

Surgery may be recommended to prevent further decline and, when possible, allow neurological improvement.

Anterior Cervical Discectomy and Fusion

Anterior cervical discectomy and fusion is performed through the front of the neck.

The operation may involve:

• Removing a damaged disc
• Relieving pressure on the spinal cord or nerve
• Placing a spacer or implant
• Adding bone graft
• Stabilising the treated level

It may be considered for cervical disc herniation, spinal stenosis, radiculopathy, myelopathy, or instability.

Dr. Pakzaban may discuss expected swallowing discomfort, activity restrictions, fusion healing, and the possibility of continued symptoms from other spinal levels.

Cervical Disc Replacement

In selected patients, an artificial cervical disc may be considered instead of fusion.

The artificial disc is intended to preserve movement at the treated level.

Suitability depends on:

• Location of the problem
• Number of involved levels
• Joint condition
• Spinal alignment
• Bone quality
• Instability
• Previous surgery

Disc replacement is not appropriate for every patient.

Dr. Pakzaban may compare its expected benefits and limitations with those of cervical fusion.

Thoracic Spine Conditions

The thoracic spine is the middle portion of the spine.

Conditions in this area are less common than cervical or lumbar problems but may affect the spinal cord.

Possible concerns include:

• Thoracic disc herniation
• Spinal tumours
• Fractures
• Spinal stenosis
• Metastatic disease
• Spinal cord compression

Symptoms may include mid-back pain, leg weakness, numbness around the trunk, walking difficulty, or changes in bowel or bladder function.

Treatment planning may require MRI, CT, and assessment of spinal stability.

Brain Tumours

A brain tumour is an abnormal growth within or near the brain.

Tumours may be:

• Benign
• Malignant
• Primary to the brain
• Spread from another part of the body
• Slow growing
• More aggressive

Possible symptoms depend on the tumour’s location and may include:

• Headaches
• Seizures
• Weakness
• Speech changes
• Vision problems
• Balance difficulty
• Personality changes
• Memory changes

Dr. Pakzaban may review MRI findings and determine whether the tumour should be monitored, biopsied, surgically removed, or managed with another treatment.

Care may involve cooperation with oncology, radiation oncology, endocrinology, neurology, and pathology.

Brain Tumour Surgery

The purpose of brain tumour surgery may be to:

• Establish a diagnosis
• Remove as much tumour as safely possible
• Relieve pressure
• Improve symptoms
• Prepare for additional treatment

The surgical plan depends on the tumour’s size, type, location, blood supply, and relationship to important neurological structures.

Complete removal is not always safe or possible.

Dr. Pakzaban may explain the expected benefit, neurological risks, possible need for rehabilitation, and whether radiation or medicine may be required afterward.

Pituitary Tumours

The pituitary gland is located at the base of the brain and helps control several hormone systems.

Pituitary tumours may cause symptoms because they produce excess hormones or press on nearby structures.

Possible symptoms include:

• Vision changes
• Headaches
• Menstrual changes
• Changes in reproductive hormones
• Unexplained breast discharge
• Changes related to growth hormone
• Excess cortisol symptoms
• Reduced pituitary function

Evaluation may involve:

• Pituitary MRI
• Hormone testing
• Visual-field testing
• Endocrinology assessment
• Neurosurgical consultation

Not every pituitary tumour requires surgery.

Some can be treated with medicine or monitored. Surgery may be recommended when the tumour affects vision, produces certain hormones, enlarges, or causes pressure on nearby structures.

Transsphenoidal Pituitary Surgery

Many pituitary tumours can be approached through the nasal passages and sphenoid sinus rather than through a traditional open skull procedure.

The goal may be to remove the tumour while protecting:

• The optic nerves
• Normal pituitary tissue
• Nearby blood vessels
• Other structures at the skull base

The operation may require coordination between neurosurgery, endocrinology, and ear, nose, and throat specialists.

Patients need hormone monitoring before and after surgery because pituitary function may change.

Spinal Tumours

Spinal tumours may develop:

• Inside the spinal cord
• Around the spinal cord
• Within the bones of the spine
• Along spinal nerves
• After spreading from another cancer

Symptoms may include:

• Persistent back or neck pain
• Pain that worsens at night
• Weakness
• Numbness
• Difficulty walking
• Loss of coordination
• Changes in bowel or bladder function

Evaluation commonly involves MRI and sometimes CT or biopsy.

Treatment may include surgery, radiation, medication, or coordinated cancer care.

The surgical goal may be tumour removal, diagnosis, relief of spinal cord compression, or stabilisation of weakened spinal bones.

Peripheral Nerve Surgery

Peripheral nerves carry signals between the spinal cord and the rest of the body.

They may become compressed because of:

• Narrow anatomical tunnels
• Injury
• Scar tissue
• Growths
• Repetitive pressure
• Other structural conditions

Dr. Pakzaban may evaluate whether symptoms involve a peripheral nerve, spinal nerve root, or another condition.

Testing may include electromyography and nerve-conduction studies.

Carpal Tunnel Syndrome

Carpal tunnel syndrome develops when the median nerve is compressed at the wrist.

Possible symptoms include:

• Numbness in the thumb and nearby fingers
• Tingling at night
• Hand weakness
• Dropping objects
• Discomfort while driving
• Symptoms extending toward the forearm

Initial treatment may include wrist splinting, activity changes, or injection.

Surgical release may be considered when symptoms remain significant or testing shows advanced nerve compression.

Ulnar Nerve Compression

The ulnar nerve commonly becomes compressed near the elbow.

Possible symptoms include:

• Numbness in the little finger
• Tingling in part of the ring finger
• Hand weakness
• Reduced grip
• Symptoms made worse by bending the elbow
• Loss of fine hand control

Dr. Pakzaban may compare the examination with nerve-testing results.

Surgery may involve releasing the nerve or repositioning it when conservative treatment is unsuccessful.

Hydrocephalus

Hydrocephalus occurs when cerebrospinal fluid accumulates within the brain’s fluid spaces.

Possible symptoms may include:

• Headaches
• Nausea
• Difficulty walking
• Memory changes
• Urinary control changes
• Vision symptoms
• Reduced alertness

The symptom pattern depends on the cause and speed of fluid accumulation.

Treatment may involve a shunt or another procedure that improves fluid drainage.

The need for surgery depends on imaging, symptoms, neurological examination, and the underlying condition.

Previous Spine Surgery and Continuing Symptoms

Some patients continue to experience symptoms after earlier spine surgery.

Possible reasons include:

• Recurrent disc herniation
• Scar tissue
• Adjacent-level disease
• Incomplete nerve recovery
• Spinal instability
• Hardware problems
• A different pain source
• Progression of the underlying condition

Dr. Pakzaban may review earlier operative reports, current imaging, and the original reason for surgery.

Another operation should be considered only when a correctable structural problem is identified and the likely benefit is reasonable.

Reviewing MRI and CT Findings

MRI provides detailed images of spinal discs, nerves, the spinal cord, brain tissue, and many tumours.

CT provides detailed views of bone and may be useful for fractures, fusion assessment, surgical planning, or patients who cannot undergo MRI.

Imaging reports may describe:

• Disc bulges
• Arthritis
• Stenosis
• Bone spurs
• Tumours
• Alignment changes
• Previous surgical changes

Some abnormalities are common in people without symptoms.

Dr. Pakzaban may compare the images with the neurological examination before determining whether a finding needs treatment.

When Spine Surgery May Be Considered

Surgery may be considered when:

• Nerve pain remains severe
• Weakness is progressing
• The spinal cord is compressed
• Walking has become significantly limited
• The spine is unstable
• A tumour or mass requires treatment
• A fracture threatens neurological function
• Appropriate non-surgical treatment has not provided enough improvement

The decision should consider both the imaging and the patient’s functional limitations.

An abnormal MRI alone does not automatically justify an operation.

Non-Surgical Care Before Surgery

Depending on the condition, non-surgical treatment may include:

• Activity modification
• Physical therapy
• Home exercises
• Medicine
• Spine injections
• Observation
• Treatment of another medical condition

A neurosurgeon may recommend continuing non-surgical care when the condition is stable and neurological function is not threatened.

Patients whose symptoms are suitable for rehabilitation or interventional care may also review Dr. Lan Nguyen’s physical medicine and rehabilitation profile.

Preparing for a Neurosurgery Appointment

Patients can prepare by bringing:

• MRI and CT images
• Written imaging reports
• Current medicine list
• Previous operative reports
• Physical therapy records
• Injection records
• Neurology reports
• Nerve-test results
• Hospital discharge papers
• A list of allergies
• Questions about treatment

It may help to record:

• When symptoms began
• Which body areas are affected
• Whether pain travels
• Whether numbness or weakness occurs
• How far the patient can walk
• Whether balance has changed
• Which treatments were attempted
• How symptoms affect sleep, work, and normal activities

A clear timeline can help separate a recent change from a long-standing condition.

Preparing for Neurosurgery

Preparation may include:

• Blood testing
• ECG
• Medical clearance
• Anaesthesia assessment
• Updated imaging
• Medicine review
• Diabetes planning
• Blood-thinner instructions
• Treatment of active infection
• Transportation and home-support planning

Patients should tell the surgical team about:

• Blood thinners
• Diabetes medicine
• Prescription pain medicine
• Supplements
• Allergies
• Previous anaesthesia reactions
• Heart or lung disease
• Sleep apnoea
• Earlier surgical complications

Patients should not stop prescribed medicine unless the surgical or prescribing team provides specific instructions.

Recovery After Spine Surgery

Recovery depends on the operation, number of spinal levels, overall health, and whether nerve damage was present before treatment.

Instructions may cover:

• Incision care
• Pain medicine
• Walking
• Lifting limits
• Sitting
• Driving
• Returning to work
• Brace use
• Physical therapy
• Follow-up imaging

Nerve symptoms may improve gradually.

Pain caused by direct compression may improve quickly in some patients, while numbness or weakness may take longer because nerves recover slowly.

Some neurological changes may remain when compression was severe or long-standing.

Recovery After Brain Surgery

Recovery after brain surgery may involve:

• Hospital monitoring
• Neurological examinations
• Imaging
• Medicine
• Incision care
• Activity restrictions
• Seizure precautions when applicable
• Rehabilitation
• Pathology review
• Follow-up with other specialists

The recovery plan depends on the location and type of condition treated.

Patients may need physical, occupational, or speech therapy when surgery affects movement, communication, balance, or daily independence.

Second Opinions

A second neurosurgical opinion may be useful when:

• A major procedure has been recommended
• Different doctors have suggested different operations
• Symptoms and imaging do not seem to match
• Previous surgery did not provide the expected improvement
• A tumour diagnosis requires a complex decision
• The patient wants to compare minimally invasive and open approaches

Patients should bring complete imaging and records so the second opinion is based on the same information used in the original recommendation.

Neurosurgical Technology and Research

Dr. Pakzaban’s professional background includes research, surgical education, and development of instruments or methods related to minimally invasive spinal surgery.

His work has included areas such as:

• Surgical localisation
• Spinal instrumentation
• Minimally invasive access
• Pedicle-screw placement
• Interbody fusion techniques
• Ultrasonic bone-cutting technology

The availability or suitability of a particular device should not determine treatment by itself.

Technology is useful only when it supports a safe procedure that matches the patient’s diagnosis.

Coordinated Neurosurgical Care

Brain and spine conditions may require cooperation with:

• Neurologists
• Physical medicine physicians
• Orthopedic specialists
• Endocrinologists
• Oncologists
• Radiation oncologists
• Pain-management physicians
• Physical therapists
• Occupational therapists
• Speech therapists
• Primary care physicians

Coordination is especially important for brain tumours, pituitary disease, spinal tumours, neurological weakness, or patients with several medical conditions.

Patients needing a neurological diagnosis before surgical treatment may also review Dr. Fayaz A. Faiz’s neurology profile or Dr. Zachary I. Smith’s neurological care.

Patient-Centered Neurosurgery

Dr. Pakzaban provides neurosurgical care based on each patient’s symptoms, neurological examination, imaging, previous treatment, medical health, and personal goals.

His clinical work may include minimally invasive spine surgery, microsurgical decompression, spinal fusion, treatment of herniated discs, brain and pituitary tumour surgery, spinal tumour evaluation, and selected peripheral nerve procedures.

Patients should confirm current appointment availability, accepted insurance plans, hospital participation, operative locations, telemedicine options, and referral requirements directly with Dr. Pakzaban’s practice.