Michael W. Meriwether, M.D., P.A.Neurosurgeon, Board Certified

Sarasota, FloridaUSA

Endoscopic Laser LumbarDisc Decompression.

UndergraduateDuke University, 1971

Medical GraduateUniversity of North Carolina, 1975

Neurosurgery ResidentBethesda Naval Hospital, 1980

Associate ProfessorUSF Medical School Tampa, FLUSUHS Medical School, Bethesda, MD

Michael W. Meriwether M.D., P.A.

Chief of Staff Doctor’s Hospital, Sarasota, FL

Patient Indications

Failure to Respond toConservative Care

History of Leg Pain Greaterthan Back Pain

Neurological Symptoms in a Sciatic Distribution

MRI Scan DemonstratingFocal Disc Protrusion

Percutaneous Technique

Minimally Invasive Percutaneous Discectomy

Outpatient Surgery

Posterior-lateral approach

Local /IV Sedation

Technique

Insertion of trocar

Cannula placement

Trephine annulotomy

Disc removal

Criteria For Success

Relief of Sciatica

Off Narcotic Medications

Return to Work/Business Functions

Conservative Care

Average Time From Symptoms Untilthe LASE Procedure

12 Months average

Average Length of Time For Conservative Care

9.4 Months average

1 - No Pain2 - Occasional Pain3 - Mild Pain4 - Moderate Pain5 - Severe Pain

Modified Magill Pain Scale

McNab Criteria

1 - Excellent

2 - Good

3 - Fair (Group placed in failure category)

4 - Poor (Failures)

Levels

L5-S1 36%

L2-3 7.1% L3-4

21.5%

L4-5 35%

0

50

. LEGBACK

LEG BACK

Pre-operative Pain

Post-operative Pain

0

50

100

1 2 3 4 5

LEG PAIN BACK PAIN

Pre-Op and Post-Op Charts

0

20

40

60

80

1 2 3 4 5

Post-Op Pre-Op

Follow Up

Office VisitMailing Questionnaire

Subsequent MRIAverage Length of Time for Post Operative

Follow-Up:

66 months average

Success Using Endoscopy Technique (McNab 1 & 2)

Follow-up @ 66 months

620

778

544

0

200

400

600

800

Total Patients Total Level Success

Success Rate

522 out of 620 = 84.20%

Failures

98/620 - 32 surgeries

15.80 % - 5.16% of the total

McNab 3 & 4 - 14 pts L-MCD 13 pts BAK-L/RTC Fusion 3 pts DLL

5 pts SCS Implantation

Additional Information

No Infections Occurred

No Nerve Root Injuries

Occasional transient Causalgia Syndrome that resolves to therapy / medications