Oblique lateral interbody fusion with O-arm navigation for lumbar hemivertebra in an adult: A technical case report

Hemivertebra is a rare congenital spinal anomaly often diagnosed in childhood due to progressive scoliosis. Initial diagnosis of hemivertebra in adulthood is uncommon, and standardized treatment protocols are not well established. This report presents a case of successful management of an L4 hemivertebra in an adult using oblique lateral interbody fusion (OLIF) with O-arm navigation. The patient, a 55-year-old, presented with chronic lower back pain and thigh pain exacerbated by standing and walking. Imaging studies revealed an L4 hemivertebra with mild scoliosis and foraminal stenosis caused by degenerative change. The patient underwent OLIF with O-arm navigation, followed by short-segment fixation with pedicle screws. Postoperative imaging confirmed appropriate implant positioning. The patient experienced complete resolution of symptoms except for mild sensory disturbance in the left thigh, with stable outcomes at the 2-year follow-up. The OLIF technique, guided by O-arm navigation, allowed precise adjustments to the anatomical characteristics of the hemivertebra, minimizing surgical invasion, and avoiding extensive corrective fixation. This approach resulted in favorable outcomes, suggesting its viability as a treatment for adult hemivertebra with minimal scoliosis. Furthermore, the use of intraoperative navigation addressed the anatomical abnormalities associated with adult hemivertebra, reducing the reliance on repeated fluoroscopic imaging and minimizing the risk of complications. OLIF with O-arm navigation is an effective and minimally invasive treatment option for adult hemivertebra, providing symptom relief and favorable outcomes.