The patient a known diabetic with arterial hypertension came to the clinic 30-May-2012 complaining of numbness four limbs more the left side with LBP for 5 years. The patient using walker for 3 years. MRI cervical spine done 04-February-2012 showing severe cervical canal stenosis C3-4, C4-5 with malacia of the spinal cord. MRI lumbar spine performed 22-November-2011 showing lumbar canal stenosis L3-4, and L4-5 with spondylolisthesis both level.

On examination, the patient is limping with exaggerated scoliotic stance with SLRS 60 degree with pain in the right and drop right foot and weak planterflexion 3/5 and hypalgesia right S1 territory.

MRI brain with MRA brain was requested and done 03-June-2012 was uneventful and cardiac consultation was acceptable for G.A.

Decompressive laminectomy of C3,4,5 and partial of C2 by using drilling the the laminae at the groove near the lateral masses and reflecting the laminae off the dura. There was no epidural fat in this area and there is overmobility of the spine.

Routine closure of the wound. Smooth postoperative recovery. The power of the upper limbs became normal and the drop feet improved slightly.

The patient has severe cervical stenosis with malacia of the spinal cord and severe lumbar canal stenosis, which mostly also needs surgical intervention. Decompression of the cervical spine take precedence and after 4-6 months decompression of the lumbar area will be discussed.