[Objective] To evaluate intermediate clinical efficacy and impact indicators in patients with combined degenerative lumbar scoliosis (DLS) in lumbar spinal stenosis (LSS) using responsible segmental decompression fusion therapy, compared with traditional decompression therapy alone. [Methods] A retrospective analysis of 88 patients diagnosed with LSS combined DL admitted to our hospital from Jan 2015 to Dec 2019, the patients were divided into two groups according to the surgical approach. Comparison of perioperative indicators, efficacy indicators and imaging indicators in the two groups of patients. [Results] (1) The duration of surgery, intraoperative bleeding and length of hospital stay were significantly lower in the study group than in the control group (P<0.05). (2) All patients were followed up for 22 to 62 months, with a mean (43.52±4.41) months. Before surgery, the VAS and ODI scores were higher in both groups; at the last follow-up, the VAS and ODI scores were significantly lower in both groups; and the VAS and ODI scores were significantly lower in the study group than in the control group (P<0.05). At the last follow-up, the total clinical efficacy of the study group was significantly better than that of the control group (P<0.05). At the last follow-up, the incidence of adverse events such as infection, delayed healing, internal fixation loosening and dysfunction was observed in both groups, which showed that the incidence of adverse events was significantly lower in the study group than in the control group (P<0.05). (3) Compared with the preoperative period, the lateral convex Cobb angle, AVT, CBD, PT and SVA were significantly reduced at the last postoperative follow-up, while the LL was significantly improved, i.e., all imaging indicators were effectively improved; and the imaging indicators of the study group were significantly better than those of the control group (P<0.05). [Conclusion] Compared with traditional long segmental decompression fusion therapy, the use of responsible segmental decompression fusion therapy has the advantages of simplicity, safety and high efficiency, and has better mid- and long-term corrective effect for patients with LSS combined with DLS, which can effectively reduce the incidence of surgical trauma and postoperative adverse reactions, improve patients' subjective perception and lumbar spine dysfunction, and thus improve prognosis and quality of life. Therefore, it is recommended to prioritize responsible segmental decompression fusion therapy based on the actual condition.