The present invention relates to a flexible laser surgical instrument for endoscopic spinal decompression and methods thereof. Various methods of accessing the epidural space with this instrument are described. The instrument design enables placement of the device through several approaches. It is then advanced under fluoroscopic (X-Ray), for example, into areas of the spine including lumbar (low back), thoracic (mid and upper back) and cervical (neck). The pathologies encroaching upon the spinal space can then be visualized wherein the epidural membrane can optionally be displaced to further aid in visualization. Methods utilizing a CO2 laser for laser ablation, for example, are employed for the removal of tissue pathologies within the epidural space.
