Osteoid osteoma is a benign bone-forming tumor that commonly affects young adults and often presents with severe nocturnal pain responsive to NSAIDs. While surgical resection is curative, lesions located in the spine, particularly near critical structures such as the vertebral artery and spinal cord, pose substantial diagnostic and surgical challenges. We report a case of a 24-year-old male with intractable night pain caused by an osteoid osteoma located at the superior margin of the right T1 pedicle. Despite extended NSAID therapy, the patient’s symptoms persisted. Multimodal imaging including MRI, CT, and PET-CT confirmed the diagnosis and revealed the lesion’s proximity to vital neurovascular structures. To minimize morbidity, we employed intraoperative O-arm navigation integrated with preoperative imaging to achieve precise localization and targeted resection through a limited posterior approach. The nidus was successfully excised en bloc without complications. Postoperatively, the patient experienced immediate pain relief and returned to normal activities within days. This case highlights the utility of real-time 3D navigation in managing spinal osteoid osteomas and supports its use as a safe, effective alternative to traditional wide exposure techniques, particularly in anatomically constrained regions of the spine.

The minimally invasive technique to correct deformity in scoliosis is not a familiar concept among spine surgeons but is interesting, as this innovative surgery, if it proves successful, will have the advantages of the minimally invasive technique in the final outcomes and will be the future of scoliosis surgery. We operated on 18 adolescent idiopathic scoliosis (AIS) patients using a newly designed technique which utilizes two or three 1-inch midline incisions to insert pedicle screws with a rod, facet fusion and de-rotation maneuver to correct the deformity. Post-operative complications were minimal and the results of the deformity corrections were comparable to the open scoliosis surgery in the follow up. The advantages of minimally invasive surgery observed in all cases include cosmetically fainter scars, reduced blood loss, shorter hospital stay, early mobilization and minimal need of analgesics for pain. Even though many challenges were faced in executing this procedure, the goal of inventing this novel approach was accomplished. We feel this technique is a good alternative to open surgery in certain curve types of AIS but large scale studies are needed in the future to recommend its routine use.

Purpose
The purpose of this study is to decrease the frequency of the perioperative complication and improve the clinical outcomes of multilevel lumbar degenerative disease by multilevel minimally invasive transforaminal lumbar interbody fusion.
Materials and Methods
317 patients(Minimally invasive transforaminal lumbar interbody fusion : 161, Conventional open surgery : 156) were followed up for more than 1 year. The age of each patient, the amount of intraoperative blood loss, the postoperative drainage, the transfusion requirement, surgery time, using of Intensive care unit, ambulation day, admission day and perioperative complications were investigated and analyzed.
Results
Minimally invasive transforaminal lumbar interbody fusion was found to have a less blood loss, less using of Intensive care unit. And as the levels of union increase, disparities were increased(p<0.05). But, surgery time of Minimally invasive transforaminal lumbar interbody fusion was longer, and as the levels of union increase, disparities were increased(p<0.05).
Conclusions
Multilevel Minimally invasive transforaminal lumbar interbody fusion can be the better way, If surgery time of Multilevel Minimally invasive transforaminal lumbar interbody fusion can be reduced.