OBJECTIVE: To investigate the effect of spinal manipulation(SM) on degenerative scoliosis by evaluating patients' visual analog scale(VAS) scores,Cobb angles, sagittal vertical axis(SVA), and apical vertebral rotation(AVR) and to explore factors that influence treatment effect.METHODS: A total of 55 patients with degenerative scoliosis received 4 weeks of SM. After treatment, patients were divided into two groups: the remission group(VAS score < 40 mm) and the non-remission group(VAS score ≥ 40 mm). Pre-versus post-treatment VAS scores, Cobb angles, SVA,and AVR were compared in each group and in the total population. Baseline data(sex, age, symptom characteristics, duration of symptoms, VAS score,Cobb angle, SVA, and AVR) were compared between groups. Factors influencing the post-treatment VAS score were explored with multiple linear regression analysis.RESULTS: No changes were found in the Cobb angle(P = 0.722) or AVR(P = 0.424) after intervention in the overall population. However, the SVA(P