Lumbar endoscopy (uni- and bi-portal)
Clinical indications
Lumbar disc herniation with radiculopathy, lumbar spinal stenosis, lateral recess stenosis, foraminal stenosis, and selected recurrent disc herniations where endoscopic decompression is appropriate.
Learning objectives
Plan approach trajectory
Imaging and palpation of the target area
Direct visualisation of important anatomical landmarks
IELD (interlaminar endoscopic lumbar discectomy): laminotomy, flavum split, discectomy (deherniation)
LE-ULBD (lumbar endoscopic unilateral laminotomy for bilateral decompression): ipsilateral/contralateral laminotomy, flavectomy (decompression)
Radiographic landmarks
Needle placement and correct docking principles
Regional foraminal anatomy
SAP exposure and osteotomy (including foraminotomy)
Discectomy steps (annulotomy)
ALIF / XLIF (lumbar interbody fusion approaches)
Clinical indications
Degenerative disc disease with mechanical back pain, spondylolisthesis, segmental instability, foraminal stenosis requiring indirect decompression, adjacent segment disease, deformity correction (including sagittal/coronal realignment), and selected revision settings.
Learning objectives
Understand relevant approach anatomy for ALIF and XLIF
Identify key anatomical landmarks on cadaveric specimens
Demonstrate proficiency in core surgical steps for ALIF and XLIF
Recognize indications and contraindications for each approach
Evaluate patient cases to select the appropriate approach for specific pathologies
Pre-operative planning and risk assessment
Safe handling of instruments and adherence to surgical protocols
Identify potential complications and discuss prevention/management strategies
Interdisciplinary planning considerations
Peer discussion around case presentations and surgical decision-making
MIS TLIF (lumbar)
Clinical indications
Grade I–II degenerative spondylolisthesis, recurrent disc herniation with instability, symptomatic degenerative disc disease, foraminal stenosis requiring direct decompression and stabilisation, and selected cases of segmental instability or adjacent segment disease.
Learning objectives
Plan and set up surgery for MIS TLIF
Correct handling and insertion of devices and implants
Positioning and identification of fluoroscopic landmarks
Execute the procedural sequence: instrument handling, exposure of neural structures, discectomy, implant insertion
Single-position prone (typically lumbar / thoracolumbar)
Clinical indications
Cases suited to combined lateral interbody fusion (where applicable) and posterior percutaneous fixation in one position, particularly degenerative pathology at the lumbar or thoracolumbar junction where efficiency and reduced repositioning are advantageous.
Learning objectives
Define indications and advantages of single-position surgery
Approach the spine from a lateral exposure in prone position
Simultaneously instrument the posterior spine using minimally invasive methods
Techniques spanning multiple levels (cervical, thoracic and/or lumbar depending on pathology)
MIS spine / percutaneous instrumentation / vertebral augmentation
Clinical indications
Percutaneous pedicle screw fixation for trauma, selected tumour/infection stabilisation cases, degenerative instability in appropriately selected patients, and vertebral augmentation (e.g., osteoporotic compression fractures, selected metastatic lesions) depending on local protocols and patient factors.
Learning objectives
Plan and set up surgery for the selected percutaneous technique(s)
Correct handling and insertion of devices and implants
Positioning and identification of fluoroscopic landmarks relevant to each technique
Execute the procedural sequence for instrument handling and implant application
