Degenerative scoliosis refers to the loss of anterior lumbar convexity and segmental kyphosis in the sagittal plane due to severe degeneration of the intervertebral discs and bilateral intervertebral joints, resulting in asymmetric gap collapse, rotational subluxation or lateral slippage of the vertebral body in the coronal plane (>10°), without a previous history of scoliosis. Degenerative scoliosis is a slow process that develops mainly in people after the age of 50, with a male to female prevalence ratio of 1:2 and a group prevalence of about 6%. The lesion is most common in the lumbar segment of the spine, with a small number also involving the thoracolumbar or thoracic segments, and the parietal vertebrae are mostly located between the two adjacent vertebrae, preferably in the L2-3 and L3-4 intervertebral spaces, often involving 2-5 segments, with a comparable probability of bending the lumbar spine to the left or to the right. Most lateral bends with a Cobb angle of <60° are often accompanied by lesions such as reduced or even absent anterior lumbar convexity, lateral slippage of the vertebral body, and narrowing of the spinal canal or nerve root canal. It leads to intractable low back pain and nerve root symptoms in the lower extremities, which can seriously affect the quality of life of the elderly. It is generally believed that degenerative scoliosis occurs gradually on the basis of degeneration and instability of the spine, including degeneration of the intervertebral discs and synovial joints, and degeneration of muscles and ligaments, but its specific pathogenesis is unclear. It has been suggested that collapse of the intervertebral complex leads to lateral displacement and rotational deformity of the vertebral body. It has also been suggested that intervertebral disc and synovial joint degeneration causing intervertebral rotation and slippage may be the initiating factor for the development of degenerative scoliosis. Anatomically, the activity of each motion segment of the spine is accomplished by a complex of two small joints in the posterior and intervertebral discs in the anterior. Asymmetric degeneration of the intervertebral discs and bilateral intervertebral small joints in the motion segment eventually causes scoliosis, rotational deformity, narrowing of the spinal canal or nerve root canal, irritation or compression of nerve roots, and a series of corresponding neurological symptoms. Asymmetric degeneration of the intervertebral discs, especially the "vacuum phenomenon", may increase rotational instability, and degeneration of the synovial joints may cause intervertebral tilt, slip, and rotational displacement, which first leads to asymmetric loading of the spinal segments and then to asymmetric distribution of the whole spinal load, which further aggravates the asymmetric degeneration. This vicious circle leads to the progressive development of scoliosis. Paravertebral muscle degeneration and fatty fibrosis in the elderly also contribute to pain, deformity, and imbalance. In addition, menopausal women are prone to osteoporotic vertebral compression fractures and vertebral wedging, leading to asymmetric loading of the vertebral body and predisposing to scoliosis progression.