Soliman, H. M., "Irrigation Endoscopic Decomressive Laminotomy.A new endoscopic approach for spinal stenosis decompression", The Spine Journal, vol. 15, pp. 2282-2289, 2015.
Soliman, H. M., "Irrigation endoscopic discectomy: a novel percutaneous approach for lumbar disc prolapse", European Spine journal, vol. 22, issue 05, pp. 1037-1044 , 2013. Abstract

Purpose The purpose of this study is to present a new endoscopic procedure, aiming to achieve the success rate equivalent to microsurgical discectomy, while addressing the drawbacks and limitations of other percutaneous techniques. Methods A series of 43 patients with uncontained lumbar disc herniation underwent surgery with irrigation endo- scopic discectomy (IED). The endoscope and instruments are placed directly over the surface of the lamina through two posterior skin portals 5 mm each without any muscle retraction or dilatation. Pump irrigation is used for the opening of a potential working space. The rest of the procedure is performed endoscopically like the standard microsurgical discectomy. Results Outcome according to modified Macnab criteria was excellent in 78 %, good in 17 %, and poor in 5 % of patients. VAS for leg pain dropped from 78 preoperatively to 7, and the Oswestry Low-Back Pain Disability Ques- tionnaire dropped from 76 to 19. The mean time for postoperative ambulation was 4 h, hospital stay was 8 h, and for return to work was 7 days. Conclusions Preliminary clinical experience with IED shows it to be as effective as microsurgical discectomy, and in comparison to other percutaneous procedures addressing noncontained herniations, a reduction in the cost, technical difficulty and surgical invasiveness has been demonstrated.

Soliman, H. M., "Cervical Microendoscopic Discectomy and Fusion", SPINE, vol. 38, issue 24, pp. 2064-2070, 2013. AbstractWebsite

Study Design. A blinded randomized controlled trial. Objective. The purpose of this study was to evaluate the cervical microendoscopic discectomy and fusion. Summary of Background Data. Minimally invasive treatment of spinal disorders allows surgeons to have direct access to the pathology with a reduced surgical morbidity, which is refl ected over the improved postoperative course. Minimally invasive techniques for cervical discectomy including the posterior microendoscopic discectomy and the percutaneous endoscopic discectomy have a high success rate but are limited by the narrow range of indications. Lately, preliminary reports about cervical microendoscopic discectomy and fusion (CMEDF) showed high success rates without restrictions in the indications. Methods. Seventy consecutive patients were randomly assigned in 2 equal groups, the fi rst operated by the “gold standard” anterior cervical discectomy and fusion and the second by CMEDF. Blinding included the patient—until dressing removal, the evaluating physician, and the radiologist throughout the entire study. The mean follow-up period was 28 months and outcome has been assessed using the Japanese Orthopaedic Association score, Odom criteria and the visual analogue scale. In addition, the operative time, complication rate, hospitalization, and the postoperative analgesic doses were recorded. Results. The functional outcome of the CMEDF at the fi nal follow- up was 91% good to excellent. Results in the open group were very similar. Meanwhile, CMEDF demonstrated improved cosmesis, reduced laryngopharyngeal complication rate, postoperative analgesics, and hospital stay. Conclusion. The results of the CMEDF are very promising. However, a much larger patient series from multicenter studies is still required for drawing up a fi nal conclusion.

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