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

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Presentation on theme: "Michael W. Meriwether, M.D., P.A. Neurosurgeon, Board Certified Sarasota, Florida USA Endoscopic Laser Lumbar Disc Decompression."— Presentation transcript:

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

2 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

3 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

4

5 Percutaneous Technique Minimally Invasive Percutaneous Discectomy Outpatient Surgery Posterior-lateral approach Local /IV Sedation

6 Technique Insertion of trocar Cannula placement Trephine annulotomy Disc removal

7 Criteria For Success Relief of Sciatica Off Narcotic Medications Return to Work/Business Functions

8 Conservative Care Average Time From Symptoms Until the LASE Procedure 12 Months average Average Length of Time For Conservative Care 9.4 Months average

9 1 - No Pain 2 - Occasional Pain 3 - Mild Pain 4 - Moderate Pain 5 - Severe Pain Modified Magill Pain Scale

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

11 Levels

12 Pre-operative Pain

13 Post-operative Pain

14 Pre-Op and Post-Op Charts

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

16 Success Using Endoscopy Technique (McNab 1 & 2) Follow-up @ 66 months

17 Success Rate 522 out of 620 = 84.20%

18 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

19 Additional Information No Infections Occurred No Nerve Root Injuries Occasional transient Causalgia Syndrome that resolves to therapy / medications


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