Methods are provided for access to a compressed space in the spinal anatomy. These methods may be used for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space. In one variation, a tissue abrasion device is provided. A cannulated probe may be placed through the neural foramina of the spine and used to position a guidewire around the anterior border of a facet joint. Once properly positioned, a medical practitioner may use the guidewire with an abrasion device to enlarge the lateral recess and neural foramina. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.