To study the application effect of ultrasonic bone knife on spinal degenerative kyphotic deformity multi-segment transarticular osteotomy (SPO). Methods The medical records of 120 patients with degenerative scoliosis of the spine from January 2015 to January 2018 were reviewed. All were treated with SPO, of which 72 patients were treated with an ultrasonic osteotomy for osteotomy. In 48 cases, conventional high-speed grinding drills were used to perform osteotomy, which was set as the conventional group. The perioperative surgical indexes and complications were recorded in the two groups. The Japanese orthopaedic association (JOA) score, visual simulation (VAS) score, kyphosis Cobb angle, scoliosis Cobb angle and Sagittal plane balance (SVA) were compared before, after 7 days, and at the last follow up. Results The operation time, single-segment osteotomy time, bleeding volume, and length of hospital stay in the ultrasonic bone knife group were significantly lower than those in the conventional group, and the differences were statistically significant (P <0.05); the VAS scores at 7 days and the last follow-up were significantly lower in the two groups Before surgery, the JOA score was significantly higher than that before surgery, and the 7-day VAS score in the ultrasonic bone knife group was lower than that in the conventional group, and the difference was statistically significant (P <0.05). There was no significant difference between the last follow-up groups (P> 0.05); 7 days after surgery, Cobb angle, Cobb angle, and SVA of the two groups were significantly lower than before surgery, the difference was statistically significant (P <0.05), and there was no significant difference between the groups (P > 0.05). Conclusion Ultrasound osteotomy for osteotomy in SPO with degenerative lateral kyphosis can reduce the time of osteotomy and surgery, reduce the amount of intraoperative blood loss, and improve the safety of surgery.