Michael W. Meriwether, M.D., P.A. Neurosurgeon, Board Certified Sarasota, Florida USA Endoscopic Laser Lumbar Disc Decompression.

Undergraduate Duke University, 1971 Medical Graduate University of North Carolina, 1975 Neurosurgery Resident Bethesda Naval Hospital, 1980 Associate Professor USF Medical School Tampa, FL USUHS Medical School, Bethesda, MD Michael W. Meriwether M.D., P.A. Chief of Staff Doctors Hospital, Sarasota, FL

Patient Indications Failure to Respond to Conservative Care History of Leg Pain Greater than Back Pain Neurological Symptoms in a Sciatic Distribution MRI Scan Demonstrating Focal 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 Until the LASE Procedure 12 Months average Average Length of Time For Conservative Care 9.4 Months average

1 - No Pain 2 - Occasional Pain 3 - Mild Pain 4 - Moderate Pain 5 - Severe Pain Modified Magill Pain Scale

McNab Criteria 1 - Excellent 2 - Good 3 - Fair (Group placed in failure category) 4 - Poor (Failures)

Levels

Pre-operative Pain

Post-operative Pain

Pre-Op and Post-Op Charts

Follow Up Office Visit Mailing Questionnaire Subsequent MRI Average Length of Time for Post Operative Follow-Up: 66 months average

Success Using Endoscopy Technique (McNab 1 & 2) 66 months

Success Rate 522 out of 620 = 84.20%

Failures 98/ surgeries % % of the total McNab 3 & 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