Corrective surgery for adult spinal deformity (ASD) patients is often difficult to pursue due to the high risks associated with advanced age, osteoporosis, or multiple comorbidities and complications. For such patients, palliative surgical approaches, including decompression and soft stabilization, offer a viable alternative. Techniques like Open Midline Decompression and SH Lee Ligament Reconstruction focus on alleviating symptoms, preserving motion, and minimizing complications. These methods have shown improvements in pain relief, functionality, and long-term stability, and can provide an effective treatment option for patients unable to undergo traditional corrective surgeries.