Treatment 42 yr congenital scoliosis hemi vertebrae L4 has lead to osteoarthritis in lumbar, fractured pedicles, stenosis + degeneratIve discs L4 l5?

See ortho spine doc. You may need reconstructive or supportive surgery to prevent nerve damage if you have more than one vertebral body affected by the osteoarthritis. If this is a congenital issue an ortho spine doctor would give you the best advice on how to proceed safely.