The patient  came to the clinic 01-April-2012 complaining of left sciatica for for 8 months and the last 2 months of severe weakness and difficult walking.

MRI lumbar spine performed 11-March-2012 showing bulge disci L3-4, L4-5 and L5-S1 with a mass in the pelvic area.

On examination, the patient walking with the help of 2 persons. There is profound weak four limbs  more weak in the left 3/5 and the right were around 4/5. The level of weakness was up to the C3 level. There is hypalgesia of the entire right leg. Hoffmann was positive in the left upper limb with DTR more exaggerated in the left. SLRS was 45 degrees in the right and 40 degrees in the left due to weakness. There difficult micturition the last month. The patient was unable to extend his left hand.

The patient was sent for MRI of the brain , cervical and dorsal spine, which confirmed the presence of severe cervical canal stenosis with huge extruded disc C3-4 and C4-5 with malacia of the spinal cord at these level. The pelvic mass proved to be a migrating downward kidney. The other kidney is missing.

Transnasal intubation failed for what per-mouth standard one applied. Discectomy of C3-4 and C4-5 with osteophytectomy until the dura was seen at the entire posterior borders. Insertion of Fidji cages 12x15x6.9 mm to C3-4 and 12x17x6.1 mm to the C4-5 levels with NovaBone. Trinica 42 mm length 2 level was applied to fuse C3-4-5 with 2 fixed screws 14x4.2 mm to C4 and variable 14x4.2 mm to C3 and C5 bodies. Check image-intensifier was done at all stages of surgery.

Routine closure of the wound. Smooth postoperative recovery. The power of four limbs dramatically improved.

The patient showed immediate postoperative recovery. This cannot be explained by just decompression. There must be unknown to us factors that trigger this improvement.