The patient came to the clinic 24-August-2013 complaining of neck pain for 3 years with numbness both hand when bending the head. The last three months dramatic deterioration with weak both upper limbs more the left.

On examination: the patient has neck pain when turning the head to the left. There is hypotrophy interossii both hands more the left. All muscles left upper limb 3/5 and right upper limb 4/5. There is hypalgesia of both hands more the left. There is weak dorsiflexion left foot 4/5.

MRI cervical spine done 29-August-2013 showing disc C5-6 with huge extrusion more to the left with central extrusion of C6-7 with malacia of the spinal cord at these levels.

Using C-arm, the C5-6 level identified. Discectomy of C5-6 and C6-7 was performed, until the dura was seen at both levels. The extruded disc material was partially calcified and it was necessary to drill out some of its parts. Vitatech cages 6.5 height were inserted to both disc spaces. 2 level 46 mm length bended more at its inferior third to accept the natural curve of the C6-7 area was inserted and using 6 screws 4x16 mm were used to fuse C5-6 and C7. All stages of surgery were done with C-arm control. Routine closure of the wound

Smooth postoperative recovery. The power of  left foot became normal and the power of both upper limbs improved slightly. 

The patient has severe compression from the extruded calcified disc. Anterior approach is the adequate solution in this case.