DYNESYS® fixation in elderly scoliosis treatment was introduced about 20 years ago. In elderly patients with mild degenerative, de novo, lumbar scoliosis without sagittal imbalance, pedicle screw-based dynamic stabilization permitted to maintain a satisfying, balanced spine at follow-up: This procedure was less invasive, with a short operative duration, limited blood loss, and low adverse event rates. Recently, DYNESYS® instrumentation has been employed by other authors in more complex cases of scoliosis, characterized by sagittal imbalance, obtaining good results, and such use can open a new avenue for the treatment of adult scoliosis with this system.