We followed up and analysised 25 patients with slight painful scoliosis including symptoms, signs, images, as well as treatment and effects. The results showed that the mild scoliosis with rotation in lumbar and thoracic-lumbar region will develop and aggraviate with age. In the elderly, it may cause severe low-back pain intermittent claudication and neurological defect of lower extremities due to stenosis and spondylolethesis. We think this kind of patients should be treated with the anterior Zielke operation in early stage in order to correct rotation and prevent the later stage problems. If the symptoms and signs as described above have occured, surgical decompression and internal fixation should be recommended, the operative treatment is more effective than the non-operative treatment.