The patient came to the clinic 28-April-2004 complaining of neck and LBP for 10 years. Numbness four limbs for 1 year. Not diabetic nor hypertensive. MRI lumbar spine done 04-November-2003 showing huge extrusion L4-5 and cervical showing extruded disc C3-4, 4-5. Brain MRI showing scattered infarctions all over. The patient was treated conservatively, then came 25-July-2004 with new MRI cervical spine done 22-July-2004 showing huge extruded disc C3-4 compressing the spinal cord. Concerning the extruded disc of L4-5, it was decided to resolve it after eliminating the pressure effect at C3-4.

On examination, the patient in agonizing pain, having neck pain when turning the head to all directions. He has also LBP with left sciatica. There is difficulty in walking. There is severe weak grip and extension right hand 3/5 and right triceps muscle 3/5. There is hypalgesia of the ulnar distribution right hand.

Using the C-arm, the level of C3-4 was identified and discectomy of C3-4 was performed and the extruded pieces were removed until the dura was seen at the bottom of the removed disc cavity. Routine closure of the wound. Smooth postoperative recovery. The power of the four limbs dramatically improved.

The patient came to the clinic 07-August-2004 with clean wound and still having mild weak left triceps muscle.

The patient over the years came several times and there was lipoma at the left side of the neck back. Then he came 11-June-2010 with manifestations of Lumber canal stenosis with MRI lumbar spine performed 08-June-2008 showing stenosis at L1-2. 2-3. 3-4 and was given admission. Frozen right shoulder.

The patient then came 06-July -2011 with new complans.

The recurrence rate in cervical disc surgery is zero. Another disc can cause de novo extrusion.