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ns with CKD. Treatment of low back pain (LBP) associated with elderly degenerative lumbar scoliosis (DLS) remains controversial. We have developed percutaneous intervertebral-vacuum polymethylmethacrylate injection (PIPI) targeting to the intervertebral vacuum as a minimally invasive surgery. The present study compared the long-term clinical outcomes of PIPI to that of nonoperative treatment. Patients with de novo DLS, aged ≥ 65years, who had LBP with visual analog scale (VAS) of ≥ 50 for ≥ 6months with intervertebral vacuum