The patient came to the clinic 29-April-2013  telling that he improve for long time after the performed to him surgery in 27-May-2003. The last year got weak right lower limb with right sciatica. The last 5 months the sciatica became bilateral with weak both lower limbs and numbness both hands the last 4 months. The patient underwent cardiac catheterization  2006 without stinting. He is under hypocoagulation therapy with arterial hypertension for 11 years.

MRI of lumbar spine done 11-February-2013 showing mild spondylolisthesis L4-5. MRI cervical spine done 01-April-2013 showing severe cervical canal stenosis C5-6, C6-7 due to massive OPLL at these levels with malacia of the spinal cord.

On examination: The patient is limping. There is weak grip left hand and extensors both hands and both triceps muscles -4/5. Weak dorsiflexion both feet 4/5 and hypalgesia below left D11 and dense anaesthesia below right D11.

The patient was sent for new investigations and MRI dorsal spine performed 04-May-2013 showing small disci D4-5, 6-7, 7-8 D11-12. Dynamic studies of the cervical spine showing anterior calcification of C4-5, C5-6, C6-7.

Using high speed drill, decompressive laminectomy C4,5,6 upper half of C7 and lower half of C3 was done. There was no epidural fat at the decompressed segments. The procedure was done in  a way to avoid any surgical trauma to the spinal cord.

Routine closure of the wound. Smooth postoperative recovery.

The patient has progressive OPLL which caused severe cervical canal stenosis over the years. Decompression is the only means to stop escalation.