From the first day of learning percutaneous laminectomy techniques, I asked myself this question, “Is there a bright future for spinal endoscopy? Is it a fad or does it represent a real trend for the future?” Although there have been many masters who have demonstrated the favorable efficacy of intervertebral endoscopic surgery at national and international congresses, there was always a wave of worry when I first started with intervertebral endoscopy. When I was an orthopedic resident, thoracoscopic scoliosis orthopedics represented a trend and the high point of technology in spinal orthopedic surgery. More than 10 years ago, Peking Union Medical College Hospital (PUMC) and Nanjing Gulou Hospital (NGLH) were the first in China to develop thoracoscopic scoliosis orthopedic surgery, which was the first trend in the country. When I visited TSRH in the United States, I was amazed to see Dr. Sucato performing thoracoscopic revision surgery for scoliosis. The skill of these pioneers was a source of admiration for me as a young surgeon. However, ten years later, the wave has passed, and very few spine surgeons around the world still insist on using thoracoscopic techniques to perform anterior release or orthopedic surgery for scoliosis. Is thoracoscopic scoliosis orthopedic surgery not minimally invasive enough? Why didn’t this technique eventually become popular? Obviously, it is minimally invasive enough compared to traditional anterior open scoliosis surgery, but what are the factors that prevented this technique from becoming popular? A few of the main problems that have prevented thoracoscopic scoliosis orthopedics from becoming popular and sticking are: narrower indications, too difficult a learning curve, and more complications. Will the intervertebral foramenoscopic technique repeat the same mistakes? The main disease that intervertebral foraminoscopic surgery targets is lumbar disc herniation, which is common and frequent compared to scoliosis, so even with a strict grasp of the indications, there are a large number of clinical cases for spine surgeons to practice. So is laminectomy learnable? From my personal experience, laminectomy technique can be divided into 3 main parts: puncture technique, tube placement technique, and microscopic operation technique. In fact, from the history of the development of laminectomy technique, the current spinal endoscopic technique of percutaneous foraminal approach is a hybrid and fusion of percutaneous puncture technique and arthroscopic technique. After years of development, percutaneous discectomy and suction, an indirect decompression procedure, has evolved into endoscopic decompression surgery with direct visualization, which greatly improves the clinical outcome, and the bridge in the middle is the “tube placement technique”. Through good preoperative design and the crucial foramenoplasty technique, the working channel reaches the “target” position proposed by Prof. Zhou Yue, so as to fulfill the demand for precision surgery, not only removing enough disc tissue and completing the whole decompression of the nerve root, but also minimizing the side injuries brought about by the surgery, so as to achieve the goal of minimally invasive surgery. Surgical goal. Compared with general anesthesia, local anesthesia is less traumatic to the human body, which is in line with the concept of “rapid recovery surgery”, and the patient recovers more quickly after surgery. Successful intervertebral foramenoscopy surgery will have an “instantaneous” magical effect, those who suffer from sciatica lumbar disc herniation patients immediately after the surgery, the pain immediately disappears, the surgeon’s heart will reap a sense of accomplishment. However, this is not all of the intervertebral foraminal surgery! Interlaminar lumbar discectomy still has a very steep learning curve, and the hardest part is to establish a three-dimensional anatomical feel of the spine in the mind. Whether it’s the C-arm fluoroscopic image we are faced with during puncture and placement, or the microscopic image we are faced with during microscopic manipulation, they are all two-dimensional, and we have to translate that into a three-dimensional image. The author’s greatest experience in the process of learning is to standardize the operation step by step, and to strictly select the surgical indications when just starting out, from simple to complex; to guard the clumsiness, do not take advantage of the trickery, and to do a good job of intervertebral foramenoplasty step by step, so that the working channel reaches the target position is the key to the success of the operation. Although there is a learning curve for intervertebral foraminoplasty technique, it is still learnable and its steps are programmed and standardized. There are many classes on intervertebral foramenoscopy, cadaveric anatomy training courses, a large number of video textbooks, and many spine surgeons who have successfully mastered this technique. By asking and learning more, we can master this new technique more quickly. Although laminectomy is a minimally invasive surgery, small surgeries can lead to big problems, and the slightest mishap can cause nerve damage and even serious consequences like death. Spine surgeons also have to make sacrifices, and the procedure inevitably involves some degree of radiation exposure. Overall, the excellent rate of lumbar discectomy under laminectomy can reach the level of 90-95%, and the recurrence rate is at the level of 2.4-6.9%. The key is to master the technique of microscopic operation, to achieve adequate decompression of the space around the nerve root, after decompression the nerve root can be seen to be reset back, microscopically the nerve root can be seen to be filled with blood vessels, the dura mater and the nerve root can be seen to be well pulsed, the intraoperative straight-leg raising test becomes negative and the nerve root can be seen to be able to glide freely. To summarize, percutaneous intervertebral foramenoscopy technology as a representative of spinal endoscopic surgery represents the development direction of spinal surgery. In the author’s eyes, it is not a lofty technique, but a technique that an ordinary spine surgeon can master with hard work, and thus has a good vitality. It can really bring good results and less trauma and faster recovery to patients! Looking back at the history of spine surgery, we can summarize it as a series of attempts to make decompression, fusion fixation and correction of deformities of the spine safer and more effective for the spine surgeon. Over the course of a century-long process, spine surgery pioneers overcame difficulties with great dedication and indefatigable efforts to achieve great results. Nowadays, spinal endoscopic technology is still in its infancy, its main goal is to obtain decompression of nerve roots, and the spinal surgical problems it can solve are still limited. If more complex spinal diseases are to be solved, our spine surgeons need to master a variety of minimally invasive spinal techniques and make a good combination of them, which should ultimately present patients with less trauma and faster recovery.