The patient came to the clinic 07-January-2012 complaining of neck  and LBP without sciatica for 15 years with exacerbation of neck pain and left upper limb. On examination at that time; she had pain when turning the head to the right up and down. She had swan-neck manifestation of the fingers both hands with weak grip, extension right hand 4/5 and the right triceps 4/5. There was also weak dorsiflexion right foot 4/5. MRI lumbar spine done 02-December-2011 showed bulge L4-5 and L5-S1. MRI cervical spine performed 27-January-2012 showing PCD C5-6 and C6-7. The patient with conservative measures improved and disappeared. The patient then came 22-March-2015 complaining of exacerbation of the neck and low back pain the last month with exacerbation of pain both upper limbs. Cervical MRI done 05-March-2015 showing the extruded disci C5-6 and C6-7 with anterior compression with malacia of the spinal cord. EMG done 08-March-2015 confirming the presence of bilateral CTS. MRI lumbar spine done 18-August-2014 showing spondylolisthesis L4-5.

On examination: the patient has pain when turning the head to all directions. Weak grip, extension right hand and the right triceps muscle 4/5.

Using the C-arm, the level of C5-6 was identified and discectomy of C5-6 and C6-7 was achieved until the dura was seen all over. 2 Solis cages were inserted to the disc spaces with bone graft. Reflex 2 level plate, bended to accept the natural curve of the patient spine with 6 4.5x14 mm screws were used to fuse C5-6 and 7. All stages of surgery were done with C-arm control.

Smooth postoperative recovery. The power of right upper limb improved considerably.

The patient recovery was immediately after surgery.

With C5-6-7 area needs to performed more lordosis of the manufacturer construct to accept the patient alignment.