Abstract: Objective：To investigate the factors affecting health-related quality of life (HRQOL) in patients with degenerative lumbar scoliosis following posterior spinal instrumentation and fusion. Methods：Clinical data and demographics of patients who underwent posterior spinal instrumentation and fusion for degenerative lumbar scoliosis from July 2011 to July 2015 were collected, the Scoliosis Research Society (SRS)-22 scale was used to evaluate the changes of postoperative HRQOL, and multivariate logistic regression analysis was performed on the relevant factors of HRQOL to screen the main influencing factors. Results：A total of 221 patients were included in the study. Among them, 93 (42.1%) patients had excellent recovery, 73 (33%) patients had improvement, 26 (11.8%) patients had no change, and 29 (13.1%) patients had worsening. According to multivariate logistic regression analysis: age between 60 and 70 years (OR=2.512, 95% CI 1.231-4.262), American Society of Anesthesiologists (ASA) grade <3 (OR=2.884, 95% CI 1.627-5.667) were predictors of postoperative HRQOL improvement. Presence of complications (OR=0.211, 95% CI 0.128-0.824), number of osteotomy >2 (OR=0.320, 95% CI 0.180-0.943), and fusion to the sacral (OR=0.300, 95% CI 0.021-0.671) has negative impact on the HRQOL recovery. Conclusions：The main factors affecting the improvement of postoperative HRQOL in elderly patients with degenerative lumbar scoliosis were age, ASA grade, level of distal fusion vertebrae, number of osteotomy, and incidence of complications.