As an aging society progresses, the number of elderly patients suffering from degenerative spinal diseases is increasing rapidly. Accordingly, fusion surgery, which was considered as a gold standard treatment for patients with severe disc degeneration, is gradually showing it’s limits. In elderly patients, the incidence of pseudoarthrosis, instrument failure, and ASD increases after fusion surgery due to naturally accompanying osteoporosis. Therefore, the reality is that many elderly patients are living with pain only with medication without undergoing surgery despite having spinal disease that requires surgery. The 'Ligament Reconstruction' covered in this book is a new treatment that can cure these patients, and it is a groundbreaking surgical method that can perform soft stabilization with sufficient nerve decompression. In particular, it is thought that elderly patients diagnosed with multiple spinal canal stenosis will be freed from pain with this new surgical method. This book introduces the pathophysiology of spinal stenosis, the characteristics of Sagittal and Horizontal (SH) ligament, and various methods of surgery using SH Ligament.