The patient came to the clinic 03-November-2014 complaining of difficult walking for 1 year and using crutches for this period. 3 months ago the patient felt down. The next day he felt more deterioration of his walk . The last 10 days he became unable to walk and came in wheelchair. MRI cervical spine done 26-October-2014 showing severe cervical canal stenosis C3-4, 4-5, 5-6 and C6-7 with malacia of the spinal cord. MRI brain unremarkable changes compatible with age. MRI lumbar spine showing LCS L4-5 and L5-S1. The patient is a known diabetic for 3 years and with arterial hypertension for 15 years.

On examination, the patient in wheelchair. Loss of hearing right ear for 30 years. There is hypalgesia both sides from C3 and below. There is atrophy of both interossii muscles both hands. The power of both upper limbs range from 4-3/5 with more weakness of the left side with inability to extend the left hand. The power of both lower limbs range from 4- -3/5 with the left lower limb more weak. There is areflexia all over with Babinski positive both sides.

The patient was sent for cervical X-ray with dynamic studies to rule out instability. Cardio consultation approved his tolerance for surgery.

Decompressive laminectomy of C3,4,5,6 and upper fourth of C7. There is no epidural fat and the dura was transparent at several places. Strict hemostasis. Routine closure of the wound.

Smooth postoperative recovery. The power of the right hand became better.

The patient still has a progressive disease, the earlier the surgical decompression the better the recovery.