Efficacy and Safety of Foraminoplasty Performed Using an Endoscopic Drill to Treat Axillary Disc Herniation.

OBJECTIVE: To evaluate the efficacy and safety of foraminoplasty using percutaneous transforaminal endoscopic discectomy (PTED) (performed with the aid of an endoscopic drill) to treat patients with axillary disc herniations. METHODS: From October 2016 to October 2018, 83 patients with single segmental axillary disc herniations diagnosed via magnetic resonance imaging who had undergone PTED were retrospectively evaluated. Of these, 38 and 45 underwent foraminoplasty using a trephine and an endoscopic drill, respectively. The two groups did not differ significantly in terms of age, gender, the herniated segment, the preoperative visual analog score (VAS), or the Oswestry disability index (ODI) (all P > 0.05). Foraminoplasty-related index scores were recorded. RESULTS: We found no significant between-group difference in the VAS and ODI scores at any time after surgery; in contrast, the scores had improved significantly compared to those before surgery (both P < 0.05). Compared to the trephine group, the fluoroscopy time was shorter in the endoscopic drill group but the foraminoplasty and total operation times longer. CONCLUSION: Foraminoplasty featuring endoscopic drilling can be used to treat axillary-type lumbar disc herniations. The radiation exposure time is less than that of the trephine approach, but the drilling approach is less efficient. The short-term clinical outcomes afforded by the two methods do not differ.