Abstract: [Objective] To explore the effectiveness and the safety of K-wires anchoring combined with visual trephine for foraminoplasty in percutaneous endoscopic medial foraminal discectomy (PEMFD).[Methods] A retrospective study was conducted on 93 patients who underwent PEMFD for single segmental lumbar disc herniation (LDH) in our department from June 2019 to January 2022. Of them, 45 patients had medial foraminoplasty conducted by visual trephine , while the remaining 48 patients received medial foraminolasty with K-wires anchoring combined with visual trephine. Perioperative, follow-up and imaging data were compared between the two groups.[Results] All patients in the two groups were successfully operated on without serious complications.The K-wires group consumed significantly shorter surgery time, associated with significantly less fluoroscopy frequency . The follow up period lasted for more than 1 year, and no reoccurrence of LDH happened in any patient of the both groups. The VAS, ODI and JOA scores significantly improved over time in both group (P<0.05) , nevertheless no significant difference in any aforesaid parameter between the two group was proved at any matching time point (P>0.05) . Based on the MacNab''s criteria, there was no significant difference in excellent and good rate of the clinical consequences between the two groups at 12 months postoperatively (88.89% vs 89.58% , P>0.05) . Radiographically, the spinal canal area was significantly increased (P<0.05), whereas the intervertebral height, horizontal displacement and angular displacement of involved segments remained unchanged in both groups at the last follow-up compared with those preoperatively (P>0.05). At corresponding time points, there were no significant differences in these parameters between the two groups (P>0.05) .[Conclusion]The K-wires anchoring combined with visual trephine used in media foraminoplasty considerably enhance the efficiency of PEMFD for the treatment of single segmental LDH.