The patient came to the clinic 20-January-2014 complaining of ataxic gait and numbness four limbs less the right upper limb for 5 years with difficult walking with progressive course MRI cervical spine done 19-January-2014 showing severe cervical canal stenosis C5-6 and C6-7 with malacia of the spinal cord with old extruded disc C5-6 right side.

On examination; the patient has wide based gait. Romberg position- swaying to all directions. There is limitation of neck movement to all directions with pain. There is severe atrophy interossii both hands with anaesthesia left ulnar distribution with weak grip both hands 4/5 and extension both -3/5, both triceps 2/5. Hoffman  positive both sides. There is pronounced weak both lower limbs 3/5 left foot and -3/5 right leg  with exaggerated deep reflexes.  Diabetic neuropathy both feet. Babinski ? right side.

Decompressive laminectomy of C4,5,6 and upper 3/4 of C7 with preservation of the spinous process of C7. Foraminotomy right C6 root and inspection of the C5-6 extrusion was bony hard. There was no epidural fat. Routine closure of the wound.

Smooth postoperative recovery. The patient showed dramatic improvement.

The patient has progressive cervical canal stenosis. The sooner the surgical intervention, the better the postoperative outcome.