The patient came to the clinic 31-July-2012 complaining of neck pain for 5 months with both shoulders pain more the left and numbness both hands.

MRI cervical spine done 26-July-2012 showing huge extruded disc C3-4 with malacia of the spinal cord and extruded disc C4-5 more to the left and C5-6 more to the right.

On examination, the patient has pain when bending the head to the left with weak extension both hands 4/5 and triceps both upper limbs 4/5. The patient is urging for surgery.

Discectomy of C3-4, C4-5 and C5-6. The dura over the C3-4 was seen all over. Insertion of Alphatec Spine cervical cages (RF) 15x12x5 mm to the C3-4 and C4-5 levels and 15x12x4.5 mm to C5-6 level. After checking the proper length a 57 mm Trestle plate 3 level was inserted and fusion using 4 variable screws to C3, C6 and 4 fixed screws 4x14 mm length to C4, C5 bodies. All stages of surgery were performed under image-intensifier.

Routine closure of the wound. Smooth postoperative recovery. The power of both upper limbs became better.

The patient has one big extrusion and 2 lesser in size. Fusing the upper C3-4 segment will trigger the lower segments, for what they were included in the surgical management.