Definition: degenerative lumbar scoliosis belongs to the category of adult scoliosis and is defined as a scoliosis deformity due to degenerative spinal degeneration in a skeletally mature patient with a Cobb angle greater than 10? and usually less than 40? The clinical features of degenerative lumbar scoliosis are segmental instability with age and the resulting progressive deformity and pain. The prevalence of degenerative lumbar scoliosis in the general population is 1.4-12%. The pathologic basis of degenerative lumbar scoliosis includes degeneration of the lumbar discs, degeneration of the small joints and changes in their orientation, changes in the morphology of the spinal canal of the corresponding segment, and the development of spinal stenosis. Lumbar scoliosis tends to lead to segmental instability: lateral slippage and rotation of the vertebral body in combination with the scoliotic segment; changes in local force lines; strain on the soft tissue of the lumbar muscles on the convex side, spasm on the concave side, and chronic inflammation; lateral slippage and rotation can cause strain on the nerve roots and corresponding symptoms; and compensatory loss of lumbar physiological pronation often occurs. Degenerative lumbar scoliosis is closely related to osteoporosis. The incidence of lumbar scoliosis in patients with osteoporosis is significantly higher than normal. Osteoporosis leads to asymmetric fractures of the vertebral body, resulting in scoliosis with the fracture side being the concave side. Asymmetric intervertebral space collapse leads to increased forces on the severely collapsed side, producing trabecular microfractures and further aggravating scoliosis. The clinical manifestations of degenerative lumbar scoliosis are: recurrent episodes of low back pain that progresses rapidly, is not easily relieved by medication, and increases with activity. The symptoms are long-lasting, recurrent, and worsen from year to year. Patients may present with intermittent claudication, and their nerve compression symptoms occur mainly on the concave side (narrowing of the nerve pathway) or on the convex side (stretching and displacement of the nerve). Patients often exhibit the morning lightness and evening heaviness of low back pain, i.e., low back pain is lighter in the early morning, due to resting overnight. However, with the activity during the day, gradually in the afternoon or evening, the low back pain is felt to increase and it is difficult to support the body, so that the pain has to be alleviated by bending over and tilting the trunk forward. Some patients need to rest in bed. For severe cases, only 1-2 hours of more comfortable time in the morning is available. Mild scoliosis and milder symptoms can be relieved by conservative treatment, including bed rest, pain medications, physical therapy, and functional exercises. For significant low back pain caused by severe degenerative lumbar scoliosis, conservative treatment is often ineffective and requires surgery. The surgical approach is based on long-segment scoliosis orthopedic internal fixation to restore the normal curvature of the patient’s lumbar spine and the balance of the spine and rebuild stability.