Practical Curriculum

This index explains the teaching themes for Dervan. It is a modular curriculum rather than a fixed daily timetable. The final programme will identify which modules, demonstrations and practical activities are included in your cohort.

Module 1 Clinical reasoning and target identification

Study the relationship between symptoms, examination findings and imaging. Discuss alternative explanations, uncertainty and the reasoning behind non-operative care, further assessment or surgical consideration. The GORE Matrix, sign and algorithms are introduced as part of Dr Gore’s teaching framework.

Learning task: present a case with a clear clinical question and explain the evidence for your proposed target.

Module 2 Anatomical orientation and imaging

Relate models and cadaveric anatomy to CT and MRI. Study the foramen, disc, facets, ligamentum flavum and neural relationships. Use the zone-and-wall framework to describe location consistently.

Learning task: identify relevant landmarks across imaging planes and state what remains uncertain.

Module 3 Foundations of transforaminal endoscopy

Review patient positioning, access planning, local-anaesthesia concepts, fluoroscopic orientation, equipment and instrument handling. Study how the working corridor relates to the intended target.

Learning task: explain the planned corridor and demonstrate selected access tasks under faculty supervision.

Module 4 Lumbar disc surgery concepts

Discuss disc-related targets, case selection, procedural sequence and recognition of relevant anatomy. Review examples to understand how the plan changes with the location and character of the pathology.

Learning task: explain the case plan, anatomical landmarks and limitations of the proposed approach.

Module 5 Lumbar stenosis and SMRUTII concepts

Apply the three-zone, three-wall framework to stenosis anatomy. Correlate CT, MRI and cadaveric findings. Discuss the relationship between target identification, approach selection and the SMRUTII concepts taught in the program.

Learning task: map a finding by zone and wall, then discuss the rationale and limits of the proposed access.

Module 6 Cadaver practice and clinical observation

Use faculty feedback to refine orientation, instrument handling and selected technical tasks. Connect laboratory work with case discussions and available clinical observation. Activities are adapted to the confirmed program and trainee level.

Module 7 Review and continued development

Review selected cases, discuss complications and limitations, and identify areas requiring more supervised experience. Agree on an individual study plan and enquire about further mentorship where appropriate.