Background: The use of navigation guidance during vertebral interbody work can be utilized to enhance surgeon visualization of the anatomy and subsequently improve cage placement accuracy.

Case Description: In this case, we present a 62-year-old male with a degenerative coronal and sagittal imbalance and lumbar stenosis causing low back pain, radicular pain, and neurogenic claudication. Surgical treatment with a fully navigated L2-3, L3-4, L4-5, and L5-S1 oblique lumbar interbody fusion (OLIF) was performed followed by posterior fusion from L2 to the pelvis.

Conclusions: To our knowledge, this was the first long-construct OLIF conducted with navigation to the S1 segment, and the second case involving a fully navigated L5-S1 OLIF cage ever performed. Patient consent was obtained for the surgical procedure and for publishing the material included in this case study.