The patient  came to the clinic 04-April-2012 complaining of neck and right upper limb pain for 5 years with exacerbation lat year and agonizing pain the last 2 months. The last month start to complain of right lower pain.

On examination, the patient has pain when turning the head to the left and down and bending the head to both sides, more to the right. She has weak grip right hand 4/5 extension of the hand and the right triceps -4/5. There is hypalgesia middle finger right hand with dyseasthesia. There is weak dorsiflexion right foot -4/5. with hypalgesia right L5 and S1 territories.

The patient was sent for investigations and MRI lumbar spine performed 23-April-2012 showing bulge L4-5 and L5-S1. Cervical MRI showing huge extruded disc C5-6 with spinal cord compression and malacia of the spinal cord with small extrusion C4-5.

Discectomy and osteophytectomy C4-5, C5-6 until the dura was seen all over the posterior border of the discectomized cavities. Cervical Fidji cages 12x17x6.1 mm were inserted to both levels with NovaBone. Zimmer Trinica plate 2 level 42 mm was used with 6 fixed screws 16x4.2 mm to fuse C4-5-6.

Routine closure of the wound. Smooth postoperative recovery and the power of right upper limb and right foot became normal.

The patient has malacia of the spinal cord. All the elements compressing or irritating the spinal cord must be resolved surgically.