The patient's relatives came to the clinic 12-February-2017 complaining of inability to walk for 12 months. They mentioned that he has profound weakness of the right upper and lower limbs. MRI of the brain showed scattered infractions of no significance with MRI of the cervical spine showing huge extruded disc C4-5, C5-6 and to lesser degree the C6-7. The extrusions were more in the right side with malacia of the spinal at these levels. There is OPLL at these levels. The patient has arterial hypertension for 2 years, under treatment. The patient is deteriorating gradually with difficult of urination for 16 months and difficult defection the last 10 days.

On examination during admission, the patient can walk with walker with difficulty, the grip of the right hand 2/5, the left hand 4/5. extension right hand 2/5, left hand 3/5, triceps both arms 3/5, weak dorsiflexion right foot 3/5, left foot 4/5, planterflexion right foot 4/5, left foot 5/5. There is hypalgesia left lower limb. Hoffmann positive both sides. Babinski positive both sides with brisk clonus both lower limbs.

Discectomy C4-5 and C5-6 until the dura was seen in the entire posterior aspect. 2 cages CFRP 6 standard with bone graft ATLANTIK Genta were inserted to the disc spaces. Skyline plate 38 mm with 2 fixed screws 14 mm to C5 and 4 variable screws 16 mm to C4 and C6 were used to fuse C4-5-6. Routine closure of the wound.

Smooth postoperative recovery. The power of four limbs dramatically improved after recovery and he was sent to the ward.

The patient the same day after several hours regained full power of all extremities and and the next day telling the sensation in the left leg has returned and urination normalized. This dramatic postoperative recovery is not the rule after such surgery.

The patient is deteriorating and surgical decompression associated with long run medications is the only solution.