The patient came to the clinic 09-January-2014 complaining of numbness of the four limbs for 1 year with difficult walking with progressive course MRI cervical spine done recently showing severe cervical canal stenosis C4-5 and C5-6 with malacia of the spinal cord. Lumbar MRI done 21-October-2013 showing severe lumbar canal stenosis L2-3, 3-4 and L4-5.

On examination; the patient walking with help of 2 persons, for what Romberg position was ignored. There is limitation of neck movement to all directions. There is severe atrophy interossii both hands more the right with anaesthesia below elbows both upper limbs with weak biceps 4/5 and below muscles 3/5 both upper limbs. Hoffman  positive both sides. There is pronounced weak both lower limbs 4/5 left foot and -3/5 right leg  with exaggerated deep reflexes.  Diabetic neuropathy both feet

The patient was sent for MRI of the brain which was done 19-January-2014 showing a cavernous angioma of the right occipital lobe receiving feeder from the posterior choroidal artery. There is periventricular changes compatible with amyloid encephalopathy.

Decompressive laminectomy of C3,4,5,6 and upper 2/3 of C7 with preservation of the spinous process of C7. There was no epidural fat. Routine closure of the wound.

Smooth postoperative recovery. The patient improved dramatically after recovery.

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