Information for Spine Surgeons



Leading the field

The Spinal Foundation is the UK’s pre-eminent resource for Aware State Diagnosis and Minimally Invasive Spinal Surgery. Under the leadership of Mr Martin Knight MD, FRCS, it has played a pioneering role in the development of such leading-edge techniques as Endoscopic Lumbar Decompression and Foraminoplasty, Cervical Endoscopic Intradiscal Disectomy and Laser Disc Decompression.

A centre of excellence

In addition to playing an active role in the diagnosis and treatment of patients with a wide range of conditions, infirmities and disabilities (click link for list). The Foundation also functions as an academic research facility and as a centre for the training of spinal surgeons. Accepting patients either by direct referral or via PCT’s for NHS treatment, it offers a compelling alternative to conventional surgery.

Improved diagnosis

Prior to the development of Aware State Diagnosis, the rationale for surgical procedures had to be based upon inappropriate diagnostic labels born from anatomy studies and the results of surgery on anaesthetised patients. In addition, deductions would be based on unloaded patterns of pain from X-rays, CAT scans and MRI scans all of which are inert and clinically distant from the pain source.

Greater understanding

The inevitable result of inappropriate diagnostic labels means that in many cases the mechanisms and sources of pain are poorly understood. In contrast, Aware State Diagnosis and Surgery has facilitated a far greater understanding of back, buttock, leg, neck, arm, shoulder, head pain. In addition, feedback from partly conscious patients has enabled us to define sources of pain and target treatment accurately.

Significant advantages

Minimally Invasive Spinal Surgery offers considerable benefits when compared to the ‘overkill’ of open surgery and the complexities of spinal fusion. Complications are significantly reduced because no general anaesthetic is required and there is minimal blood loss and tissue disturbance. Risk of nerve damage is minimised, future options are preserved and in most cases treatment is on a ‘Day Case’ basis.

Prescribed training

The widening breadth of keyhole surgery techniques for spinal intervention raises the need for improved in vivo training focused upon patient selection, supervised surgical exposure, virtual reality training and laboratory simulation. Appropriate training, including training at The Spinal Foundation, can be sought by writing to

Surgeon Training

Surgeon Training

The widening breadth of available keyhole surgery needs to be grasped by all surgeons


Technique ELDF

Endoscopic Lumbar Decompression & Foraminoplasty

This page is being updated

Endoscopic Approach

Once the index level...

X-Ray Jig Technique

 X-Ray Jig Approach Technique for Entry Portal Selection

This page is under development with diagrams & pictures and videos to be...

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