• Xiao Liang, Lijing Ran, Ning Zhai, Longao Huang, Congyang Wang, and Hua Jiang.
• Department of Spine Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, China; Department of Spine Surgery, Affiliated Hospital of Jining Medical University, Jining, China.
• World Neurosurg. 2025 Jan 28; 195: 123647123647.

BackgroundA sufficient foraminoplasty is critical in percutaneous endoscopic transforaminal discectomy (PETD) for lumbar disc herniation (LDH), which may affect the progress of surgery. This study assessed repeated foraminoplasty (RF) applied in PETD for patients with LDH and lumbar foraminal stenosis.MethodsThis study enrolled 133 patients with LDH and lumbar foraminal stenosis who underwent PETD; patients were assigned to traditional foraminoplasty (TF) and RF groups. Intervertebral foramen enlargement and ratio of nerve roots completely exposed were compared between the 2 groups. Perioperative indicators were assessed for surgical efficiency and safety. Visual analog scale score, Oswestry Disability Index score, and MacNab criteria were used to evaluate clinical outcomes.ResultsAnterior-posterior diameter increase of intervertebral foramen (P < 0.001) and ratio of the nerve roots completely exposed (P = 0.032) in the RF group were significantly greater than those in the TF group. The decompression time and total operative time of the patients who underwent RF were significantly shorter compared with patients who underwent TF (P < 0.001). With respect to evaluation of clinical efficacy, the visual analog scale score of leg pain in the TF group was greater than that in the RF group only on the first day postoperatively (P = 0.031).ConclusionsRepeated foraminoplasty applied in PETD for patients with LDH and lumbar foraminal stenosis might improve intervertebral foramen enlargement in anterior-posterior diameter, exposure of nerve roots, surgical efficiency, and immediate relief of leg pain after surgery.Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.

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