Full Endoscopic Lumbar Foraminoplasty with Periendoscopic Visualized Trephine Technique for Lumbar Disc Herniation with Migration and/or Foraminal or Lateral Recess Stenosis

PURPOSE: To introduce a newly designed periendoscopic visualized trephine system for foraminoplasty in treating lumbar disc herniation with migration and/or foraminal or lateral recess stenosis, and report early clinical outcomes evaluated by the Patient-Reported Outcomes Measurement Information System (PROMIS). METHODS: A total of 25 patients who underwent transforaminal endoscopic lumbar discectomy with foraminoplasty using a periendoscopic visualized trephine from June 2019 to January 2020 were retrospectively reviewed. PROMIS pain interference and physical function were selected as outcome measures. RESULTS: The average age of the 25 patients (16 males, 9 females) was 32.0 +/- 7.5 years (20-48 years). All patients were successfully followed up with the mean time of 10.1 +/- 2.8 months (6-12 months). PROMIS pain interference scores decreased significantly from mean 67.0 +/- 3.4 preoperatively to 37.5 +/- 5.4 at the final follow-up (P < 0.01), and PROMIS physical function scores improved significantly from mean 29.2 +/- 5.5 preoperatively to 59.3 +/- 3.7 at the final follow-up (P < 0.01). No neural or vascular complication occurred. CONCLUSION: Full endoscopic lumbar foraminoplasty with a periendoscopic visualized trephine technique is safe and effective for treating lumbar disc herniation with migration and/or lateral recess or foraminal stenosis, with improved flexibility and convenience and decreased radiation exposure.