The patient came to the clinic 29-October-2013 complaining of numbness ulnar distribution both upper limbs more the right for 18 months for what right ulnar transposition at the elbow and carpal tunnel release done in Tunis 01-January-2013 without improvement. The patient is a known diabetic.

On examination: the patient has minimal neck pain when looking to the right. There is weak extension right hand 4/5 with hypalgesia of the ulnar distribution right hand.

MRI brain done 29-October-2013 was normal, cervical spine showed very huge extrusion C5-6 with malacia of the spinal cord with bulge C4-5, C6-7.

 Discectomy C4-5, C5-6 and C6-7 with osteophytectomy C5-6 until the dura was seen all over. Fidji cervical cage 12x15x7.7 mm with NovaBone were inserted to C5-6. 12x15x5.7 to C4-5 and 12x15x6.1 mm to C6-7. Zimmer Trinica cervical plate 3 level 63 mm length was used to fuse C4,5,6 and C7. Four fixed screws 16x4.2 mm were applied to C5,6 bodies. Four variable screws 16x4.2 mm were applied to C4 and C7 bodies.

Smooth postoperative recovery.

The patient underwent release of the supposed to be entrapped nerves. Before proceeding to such a conclusion, brain and cervical spine survey must be evaluated before reaching to wrong surgical option.