Endoscopic spine surgery has evolved significantly from its initial application in lumbar disc herniation treatment to more complex procedures. The development of biportal and large-working-channel interlaminar endoscopic systems has expanded its indications to include lumbar central or lateral recess stenosis and foraminal stenosis. These advancements have made procedures such as endoscopic posterior laminotomy, laminectomy, and foraminotomy feasible, offering shorter hospital stays and faster recovery compared to traditional microsurgery. The evolution of biportal endoscopic techniques now allows for comprehensive bone work, including laminectomy and foraminotomy, across various spinal regions from cervical and thoracic to lumbosacral lesions. This broadens the range of conditions that can be treated endoscopically, including cervical central stenosis, cervical foraminal stenosis, thoracic disc herniation, and endoscopic fusion [1].