The patient came to the clinic 08-August-2004 complaining of LBP with bilateral sciatica for 1 year with minimal pain both shoulders. Felt down 01-January-2004 and got fracture right tibia. MRI cervical and dorsal spine performed 07-May-2003 showing severe cervical stenosis C5-6, C6-7 with OPLL.

On examination, the patient has severe weak grip and extension both hands 3/5 and both triceps muscle 3/5. There is hypalgesia of the ulnar distribution both sides and hypalgesia below the umbilicus down to L3 both sides. Weak all muscles both lower limbs  with Hoffman positive both sides and Babinski positive both sides with exaggerated reflexes upper and lower limbs.

The patient was sent for investigation and MRI cervical spine done showing severe cervical stenosis C4-5, 5-6 and C6-7 with OPLL.

Using the C-arm, the level of C4-5 was identified and discectomy of C4-5, C5-6 and C6-7 was performed and the extruded pieces in all levels were removed until the dura was seen at the bottom of the removed disc cavity. Using Scientx miniplate bended to adopt the natural curve of the area fusion of C4-5-6-7 with 8 screws was achieved.

Check with C-arm confirmed acceptable location of the construct. Routine closure of the wound. Smooth postoperative recovery. The power of the four limbs dramatically improved.

The patient came to the clinic 29-August-2004 with clean wound and neurologically free except for presence of the pathologic reflexes. Check X-ray showing good alignment of the construct.

The patient then came 16-February-2005 complaining of LBP for 6 months with left hip pain. Neurologically he was free except for pathologic reflexes and he was sent for investigation.

MRI cervical done 22-February-2005 was uneventful and the lumbar showed dehydrated all lumbar disci. he was treated onservatively.

The recurrence rate in cervical disc surgery is zero. Another disc can cause de novo extrusion. The sooner the decompression of the spinal cord in progressing cervical canal stenosis, the better the outcome.