The medical challenges associated with an aging population manifest themselves in a variety of specialties. In spine surgery, in addition to the common lumbar disc herniation, lumbar spinal stenosis and various types of cervical spondylosis, an increasingly serious challenge comes from scoliosis deformity in the elderly. It is common to see elderly people standing or walking with their trunk tilted to one side, sometimes with a forward tilt. They are unable to stand for long periods of time, or can only walk short distances. These elderly people also complain of low back pain, or soreness and numbness in the lower limbs, and in severe cases they need to sit down and rest for a while before they can continue walking. In the eyes of the doctor, these people may have degenerative scoliosis of the lumbar spine and may also have lumbar spinal stenosis. These common diseases and symptoms in the elderly are harmful in many ways, not only greatly reducing the quality of life and daily activities of the elderly, but also objectively accelerating the degeneration of their major organs, thus affecting their life expectancy and so on. Therefore, the elderly should pay sufficient attention to spinal deformities once they occur. How do spinal deformities appear in the elderly? We know that degeneration of the lumbar spine is associated with increased age and also with different individual lifestyles and work styles. When degeneration of the lumbar spine occurs in an asymmetrical manner, when the discs or small intervertebral joints degenerate more on one side and less on the other, the lumbar spine gradually develops curvature, which in turn becomes a lumbar scoliosis deformity. The characteristics of this degenerative deformity in the elderly are almost completely different from those of idiopathic scoliosis in adolescents. One significant difference is that adolescent idiopathic scoliosis is usually more of an aesthetic concern, whereas treatment of lumbar deformities in the elderly must focus on improving low back pain and trunk imbalance, with aesthetic requirements being relatively secondary. Surgical treatment of spinal deformities in the elderly is a more important challenge. General incisional surgery is a long procedure with high blood loss and slow recovery. Many elderly people end up having to forgo surgery because of the elevated risk of surgery due to concomitant severe underlying disease. Minimally invasive surgical treatments for geriatric spinal deformities have emerged, with the outstanding advantage of greatly reducing surgical trauma and intraoperative bleeding while ensuring surgical efficacy, thus greatly reducing anesthesia and surgical risk in elderly patients. The purpose and principles of surgical treatment of spinal deformities in the elderly is to relieve nerve compression, correct spinal deformities, and maintain spinal stability. Various minimally invasive surgical techniques are available to reflect these surgical principles. Under anesthesia, a small skin incision is made posteriorly to the spine to prevent trocar placement, which provides a good surgical view with the aid of a microscope and relieves nerve compression; similarly, a small incision is made on the side of the lumbar spine to place a surgical trocar, which not only corrects the spinal deformity by reconstructing the narrow gap between the vertebrae, but also objectively improves the nerve compression; minimally invasive percutaneous The minimally invasive percutaneous pedicle screw fixation technique greatly reduces the muscle and soft tissue trauma associated with surgery. The combination of all of these approaches offers tremendous therapeutic opportunities for the treatment of age-related spinal deformities. Minimally invasive surgery has completely overturned the established understanding of traditional surgery for spinal deformities, and blood transfusions are essentially unnecessary throughout the procedure. In conclusion, spinal deformities in the elderly are highly prevalent and harmful. Not only does it affect the quality of life of the elderly and reduce the average life expectancy, it is also associated with the image and dignity of the elderly. Minimally invasive surgery has brought significant opportunities for the treatment of spinal deformities in the elderly, and will certainly benefit millions of elderly patients.