The patient came to the clinic 10-February-2009 with history of neck pain for one year with cephalic syndrome. Two months ago got upper limbs pain with left chest pain and radiation to intrascapular region.

MRI cervical spine performed 08-February-2009 showing bulge C4-5 and  wide-based extruded disc C5-6.

On examination: the patient has limitation of neck movements with pain all directions with weak grip both hands 4/5 and extension of the fingers 3/5 and both triceps 3/5. The patient was advised to undergo conservative treatment, but she came 30-March-2009 with same clinical picture and cervical X-ray demonstrated overmobitity of C4-5. The patient is urging for surgery and she was advised to wait for another month, but 2 days later she another time urged for surgery.

Discectomy of C4-5, and C5-6 was performed and using cervical miniplate Hybrid  with 6 screws 14 mm length variable, fusion of C4-5-6 was achieved.

Smooth postoperative recovery with normalization of the power of the upper limbs.

Routine dynamic study of the cervical spine must be included in the investigations to catch if there is overmobility of some segments. In this case overmobility was the major indication for surgery and discectomy of C5-6 was performed to avoid future progression of this disc extrusion, because after fusion of C4-5, the stress points at this adjacent level will increase, for what it was included with fusion.