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This review examines the historical development of ESS, highlighting key figures and milestones that have shaped its evolution. It explores different endoscopic techniques, including transforaminal, interlaminar, lumbar fusion, cervical, and thoracic approaches. The review also provides an overview of the ongoing debate between uniportal and biportal ESS, discussing the relative invasiveness, capabilities, costs, and learning curves. In addition, it examines the complication profiles of ESS compared with open surgery as well as the economic implications of these techniques. 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