What is done? If bad bone quality (e.g. due to osteoporosis) adds to a traumatic vertebral fracture, a standard balloon cementation (kyphoplasty) of the affected vertebra is often inadequate. Due to the arising instability and the resulting malposition of the afflicted segment an additional realignment and a stabilisation with implants are required This usually means a big skin incision and a displacement of the back muscles. This would lead to a pronounced damage to these structures and a considerable pain burden for the patient from the intervention. With latest techniques and implants it is possible to achieve also a multisegment fixation and concomitant alignment through small skin incisions (percutaneously) – completely sparing the entire spine musculature. Due to the small lesions, the risk of infection or delayed healing is a lot smaller than with the common procedures. Time for surgery is greatly reduced compared to the usual open surgeries when carried out by the very experienced surgeons and safety concurrently increased. Hospital stay will be significantly shortened as the mostly only marginal post-operative pain allows for instantaneous mobilisation of the patient and no bed rest is required. Even multisegment fixations in combination with complex reconstruction procedures - like replacements of vertebrae - are feasible with this state-of-the-art endoscopic technique. If surgical treatment of the anterior spine is necessary it will not be done through big incisions in the thoracic area but through smallest access points. Then all treatments for the existing problem will be carried out endoscopically/thoracoscopically under imaging control. With this technique it is possible to treat or correct extended inflammatory processes, a tumour or misalignments.