A minimally invasive surgical system can include a cannula having a side port and an open distal end, and an expandable bone tamp. The bone tamp includes an elongate shaft coupled to an expandable element. The elongate shaft has a length adapted to align the expandable element with the side port or extend the expandable element completely beyond the distal opening of the cannula. In this manner, the cannula and bone tamp enable either directional (i.e., through the side port) or non-directional (i.e., completely outside the cannula) bone tamping.