Surgery can be considered for severe spinal kyphosis affecting gastrointestinal function in the elderly. Spinal kyphosis is also called straightening of the physiological curvature of the spine, which is generally seen in the cervical spine physiological curvature retrograde and lumbar spine physiological curvature retrograde. It is rare to find patients with kyphosis affecting gastrointestinal function due to lumbar lordosis compressing the retroperitoneal organs or intestinal tubes. Surgical treatment can be considered for patients who have failed conservative treatment or whose kyphosis seriously affects their normal working life. Surgical methods mainly include osteotomy and orthopedic surgery and combined anterior and posterior surgery. Osteotomy and orthopedic surgery is to cut off the excess bone at the back to complete the orthopedic treatment, which is suitable for patients with less involved segments; combined anterior and posterior surgery requires cutting the anterior bone bridge of the involved segments, and then fusing the anterior and posterior vertebral bodies, which is suitable for patients with more involved segments and a larger angle of the lordosis, etc. The specific surgery method needs to be determined by the surgeon according to the patient’s needs and the patient’s needs. The specific surgical method needs to be decided by the doctor according to the patient’s condition. For the same disease, patients with different physical conditions and at different stages of the disease, the treatment methods are different and should be standardized under the guidance of the doctor.