Why should i learn endoscopy??  What is an endoscope? The endoscope is a tool to achieve our purpose of relief of symptoms in a progressively degenerating lumbar spine that has changes in close proximity of neuro vascular system giving us the symptom generators.  System of surgery under local anesthesia and stitch less should be learnt due to its solid philosophy that has changed spine surgery for ever. This includes precision diagnosis of symptom generators across 3 zones and on 3 walls, better image symptom pathology correlation, ability to devise and execute a near non morbid access thru fourth zone and foramen and that is increasingly effective at target by use of added modalities like RF and Laser. It utilizes access thru natural orifice that is IV foramen under local anesthesia making it possible even to help a patient with gross medical co morbidity like cardiac, diabetes, obesity. It also has a very scientific base for chemical radiculitis, chemical discitis and related inflammatory causes treatable by non op care.