Babol University of Medical Sciences Caspian Journal of Surgery 3115-9087 1 3 2025 09 01 Lumbar Spine Ligament Augmentation Technique to Prevent Proximal Junctional Kyphosis: A Short Communication 113 116 730089 10.22088/caspjs.2025.2061891.1017 EN Ebrahim Hejazian Department of Neurosurgery, School of Medicine, Babol University of Medical Sciences, Babol, Iran 0000-0003-4540-1759 Masoud Yahyazadeh Department of Neurosurgery, School of Medicine, Babol University of Medical Sciences, Babol, Iran 0000-0003-4540-1759 Arman Ferasat Department of Neurosurgery, School of Medicine, Babol University of Medical Sciences, Babol, Iran 0000-0003-4540-1759 Hadi Ebrahimi Department of Neurosurgery, School of Medicine, Babol University of Medical Sciences, Babol, Iran 0000-0001-6855-5166 Morteza Sharifzadeh Clinical Research Development Unit of Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, I.R. Iran 0000-0003-4540-1759 Journal Article 2025 10 06 Abstract Background: Proximal junctional kyphosis (PJK) is a frequent complication following lumbar spine fusion. It may lead to loss of alignment, neurological symptoms, and the need for revision surgery. Various techniques have been proposed to reduce the risk of PJK, including ligament augmentation. Methods: We applied a simplified wire-based posterior ligament augmentation technique in 12 patients undergoing posterior lumbar fusion for degenerative conditions. A steel wire was passed through or over the spinous process of the vertebra one level above the upper instrumented vertebra (UIV+1) and secured to the construct to reinforce the transition zone. Patients were followed clinically and radiographically for 6 to 12 months. Results: No patient developed radiographic evidence of PJK, defined as a ≥10° increase in the UIV–UIV+2 angle. All fusion constructs remained stable, with no rod fractures, screw loosening, or need for revision surgery observed during the follow-up period. Conclusions: This wire-based augmentation technique is simple, low-cost, and technically feasible in routine lumbar fusion cases. While preliminary, the results suggest a potential role in preventing PJK. Further studies are warranted to validate its long-term effectiveness.

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