Retrospective functional and radiographic analysis of symptomatic patients with de novo degenerative lumbar and thoracolumbar scoliosis.To evaluate the radiographic parameters of symptomatic patients presenting with de novo degenerative adult scoliosis and correlate them with functional scores.Previous studies have been inconclusive as to the correlation of radiographic parameters and clinical symptomatology.Radiographic analysis of 58 consecutive symptomatic patients with de novo degenerative lumbar and thoracolumbar scoliosis was performed using posteroanterior and lateral 36-inch standing radiographs. Measurements included curve type, curve location, curve magnitude, coronal alignment, sagittal alignment, and anteroposterior and lateral intervertebral olisthesis. Clinical functional data were measured with Oswestry Disability Index, Roland-Morris Disability Questionnaire, and RAND 36-item Health Survey questionnaire. Correlation between clinical data and radiographic data were then calculated.Sagittal balance did not show significant correlation with functional results. However, coronal imbalance (more than 5 cm from midsacrum) affected physical function (P = 0.028) and outcomes (P > 0.05). Also, moderate to severe lateral olisthesis (equal or more than 6 mm) demonstrated higher bodily pain then mild lateral olisthesis (P = 0.005). Good lumbar lordosis correlated positively with health assessment as reflected in SF-36 score (P = 0.039, r = 0.291).Reduced lumbar lordosis and increased lumbosacral scoliosis can affect the general health status of older patients with de novo degenerative scoliosis. Lateral olisthesis, mainly, and anteroposterior olisthesis are important elements of rotatory subluxation in the lumbar curves, which are important radiographic parameters, predicting symptomatology and health status of patients with de novo degenerative scoliosis.