The patient came to the clinic 16-August-1998 with right shoulder pain for 6 months with right lower limb pain for one month. MRI lumbar spine showed PLD L4-5 and she was treated conservatively.

The patient came 26-March-2001 with exacerbation of neck pain for 6 months with headache and hypertension. MRI of the cervical spine was done 28-March-2001 showing assimilation of C2-3 which was considered as a whole as C2. There were gliotic changes in the spinal cord at C3-4 without compression. The patient was treated conservatively.

The patient came 25-May-2004 with left shoulder pain. There was weak grip, extension of the left hand and the triceps muscle left side. MRI was asked but she came 26-February-2006 with MRI bad quality showing PCD C4-5 and C5-6. She was asked to perform another MRI of the cervical spine.

The patient came 30-June-2007 with MRI performed 26-June-2007 showing retrolisthesis of C2-3 with PCD C3-4 with severe compression of the spinal cord with malacia at that level.

On examination: The patient had profound weak all muscles upper limbs more in the left side with numb both hands and Hoffmann sign positive both sides.

Discectomy of C3-4 with osteophytectomy was done. The bone was profusely bloody oozing, for what waxing was needed several times and the posterior longitudinal ligament was bony hard, for what it was necessary to drill it out, after what the dural was seen. Using 2 level cervical miniplate, fusion of C2-3-4 was done after nibbling the antero-inferior border of C3 bush it anteriorly.

Smooth postoperative recovery with normalization of the power of both upper limbs.

The patient had gliotic changes, which mostly are present for several years. Immediate improvement of the power indicate, that these changes cannot give the conclusion for bad recovery.

The aim of the surgery is arrest the escalation of deterioration. In case of improvement, it is a bonus to the patient.