[Objective]To explore the clinical efficacy of percutaneous endoscopic medial foraminal discectomy(PEMFD)with or with-out Kirschner wire positioning for the treatment of lumbar disc herniation(LDH).[Methods]A retrospective study was conducted on 93 pa-tients who underwent PEMFD using a visualizing trephine for LDH in our hospital from June 2019 to January 2022.Based on doctor-pa-tient discussion preoperatively,48 patients received PEMFD with Kirschner wire anchoring positioning,while the remaining 45 patients un-derwent the conventional PEMFD.The perioperative,follow-up,and imaging data were compared between the two groups.[Results]All pa-tients in both groups had operation performed successfully with no serious complications.The positioning group proved significantly superi-or to the conventional group in terms of surgical operation time[(44.9±3.2)min vs(54.3±3.3)min,P＜0.001]and fluoroscopy frequency[(3.4±1.1)times vs(7.0±1.4)times,P＜0.001],whereas there were no statistically significant differences in incision length,intraoperative blood loss,postoperative walking time,incision healing grade and hospital stay between the two groups(P＞0.05).All patients were followed up for 12～18 months,with an average of(14.4±5.0)months,and there was no statistically significant difference in the time to resume full weight-bearing activity between the two groups(P＞0.05).The VAS and ODI scores significantly decreased in both cohorts over time(P＜0.05),and there was no statistically significant difference in VAS and ODI scores between the two groups at any time points accordingly(P＞0.05).According to the modified Macnab's criteria,there was no statistically significant difference in the excellent and good rate of clinical results between the two groups at the latest follow-up(89.6％vs 88.9％,P＞0.05).Regarding imaging,the spinal canal area significantly in-creased(P＜0.05),while the intervertebral space height and lumbar lordosis angle remained unchanged in both group at the latest follow-up compared with those preoperatively(P＞0.05).At the corresponding time points,there was no statistically significant difference in the above-said imaging measurement indicators between the two groups of patients(P＞0.05).In addition,there was no significant change in the Pfir-rmann grade of involved discs in both groups at the last follow-up(P＞0.05),and no statistically significant difference in Pfirrmann grade be-tween the two groups at any corresponding time point(P＞0.05).[Conclusion]The Kirschner wire anchoring positioning in PEMFD for pos-terior endoscopic treatment of LDH can significantly improve surgical efficiency.
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