The patient came to the clinic 21-September-2013 complaining of difficult walking with ataxic gait for one month with bilateral sciatica more the left. He felt down several times during this period. He has tremor both hands more the right of Parkinsonian type. The patient is a known insulin dependent diabetic for 25 years.

MRI of the brain done 04-July-2013 showing mild brain atrophy compatible with age. MRI cervical spine showing severe cervical canal stenosis C3-4, 4-5, 5-6 and C6-7 with malacia of the spinal cord. Lumbar showing stenosis at L2-3, 3-4, 4-5 with extruded disc L3-4 with right upward migration.

On examination: the patient has shuffling gait with Parkinsonian tremor right hand. Romberg stable. No cerebellar signs. He has profound weak extension both hands 3/5, grip both hands 4/5, triceps both sides -4/5. There is pain of the neck when looking to both sides and bending the head to the right shoulder.

Decompressive laminectomy C3,4,5,6 and Upper half of C7. All the soft tissue and bony compressing elements were eliminated. Hemostasis with routine closure of the wound.

Smooth postoperative recovery. The power of both upper limbs improved.

The patient has progressive cervical canal stenosis. Surgical decompression is the only solution to stop the escalation of the deleterious events.