Aim. At present, there is no consensus on the approach to treatment of patients older than 60 years of age who have spinal deformity and clinical symptoms. The article describes the effect of two different types of surgery on the quality of life of elderly patients with deformities. Material and methods. A prospective study included 58 patients operated on at the Verden Russian Research Institute of Traumatology and Orthopedics in the period between 2007 and 2010. The inclusion criteria were as follows: patients older than 60 years of age, having spinal deformity (sagittal modifiers of grade 2(+) and higher according to the SRS-Schwab classification), radicular syndromes, and back pain. The patients were examined in accordance with a general algorithm, including general clinical and neurological examinations and an X-ray examination with evaluation of deformity, spinopelvic relationships, and sagittal imbalance. We compared two groups of patients. The first group included 28 patients who underwent decompressive foraminotomy. The second group consisted of 30 patients who underwent decompressive foraminotomy and deformity correction. The patients were evaluated using the following scales: VAS, ODI, and SRS-24 before surgery and after 3, 6 months, 1, 2, and 5 years. Results. Preoperatively, there was no difference between the groups. We found no differences between the groups 1 year after surgery. After 5 years, the group with isolated decompression had poorer results. Conclusion. Spinal deformity correction is a more aggressive surgical procedure compared to isolated decompression. However, the efficacy of the former operation is higher.