The patient came to the clinic 10-August-2003 complaining of neck and both shoulders pain more the right side with numbness both hands awakening her during night for 3 years progressing. MRI cervical spine before the surgery performed 28-July-2002 showed severe cervical canal stenosis C3-4, 4-5, 5-6 and C6-7. MRI performed 10-July-2003 showed extruded disc C6-7 more to the left.

On examination, the patient has neck pain when rotating the head to the left. There is weak grip, extension both hands and both triceps muscles. There is hypalgesia both median divisions upper limbs. No data support CTS.

The patient was sent for investigation and MRI cervical spine done 18-August-2003 showing showing extruded disc C4-5, 5-6, 6-7 with the dynamic studies confirming overmobility of C3-4. EMG demonstrating mild signs of CTS.

Transnasal intubation. Through anterior approach, discectomy with osteophytectomy C3-4, 4-5,5-6 and C6-7 was achieved until the dura was relax at all levels. Using Scientx cervical plate bended to accept the curve of the area with 10 screws were applied to C3,4,5,6 and C7 level. Routine closure of the wound.

Smooth postoperative recovery. Mild improvement of the motor functions upper limbs. The patient was sent to the ward.

The patient came to the clinic 04-September-2003 with clean wound with various level of improvement and still having mild weak grip both hands and hypalgesia both median nerves distribution.

The patient then came 04-October-2003 and 17-December-2003 with the same status. Check cervical X-ray showed good alignment of the construct.

The patient then came 14-December-2008 complaining of LBP with bilateral sciatica, more the left for 2 months. Neurologically she was free, except for scoliotic stance. MRI lumbar spine performed 19-November-2008 bulge L1-2, L2-3 and L4-5. She was treated conservatively.

The patient has several cervical problems over the years, which needs correction.