The severe contusion of the cervical spinal cord is unpredictable for future recovery. Some show complete recovery, others no recovery. The surgeon must provide the maximum conditions for possible recovery.

The patient suffered RTA 22-February-2003 with multi-organ injuries. He was transferred to Shmaisani hospital 04-March-2003 with stable fracture of C4 with extruded disc C3-4 and contusion of the spinal cord with deep tetraparesis below C3. MRI recently done confirming thee data.

On examination: the patient is bedridden with color in around the neck with deep tetraparesis below C3 with tetrahypalgesia.

Trans-nasal intubation. Inspection of the area for loose fragments. The integrity of C4 is acceptable. Discectomy of C3-4 until the dura was seen at the bottom of the cavity of the removed disc. No CSF leak. Routine closure of the wound. Smooth postoperative recovery. He was sent to the ward.

The patient came to the clinic 14-April-2003. The deltoids are 5/5, but all other muscles upper limbs are weak 3-4/5.Sensation recovered, Hoffmann brisk both sides. SLRS was 70 degrees right side and 30 degrees left side due to weakness. All deep reflexes are exaggerated with Babinski positive in the left with clonus left foot.

The patient then came several times showing slow recovery. He came 14-January-2003 complaining of weak left lower limb when walking more than 500 meters. Using car for 2 months. The power of four limbs is 5/6 except flexion of both hands and left quadriceps muscle 4/5. Normal micturition and defecation.

The patient last time came 21-May-2006 still complaining of dysesthesia of both hands. MRI cervical spine showing gliosis of the spinal cord at previous injury. No elements of instability.