The patient came to the clinic 27-February-2008 complaining of numbness both hands with neck pain for 3 years. The last month progressed LBP with left sciatica and inability to walk.

MRI lumbar spine done 25-February-2008 showed spondylolisthesis L4-5  with extruded disc L3-4 more to the right.

On examination: the patient came in wheelchair. Weak flexion and extension of the right hand and right triceps muscle 4/5. There is weak dorsiflexion both feet 4/5. The patient was sent for MRI of the cervical spine.

MRI cervical spine performed 01-March-2008  showing stenosis of the cervical spinal canal at C2-3, 3-4, 4-5 and C5-6, with malacia of the spinal cord.

The patient is a known diabetic with hypertension with 2 stints inserted 2002 and 2005.

Decompressive laminectomy of C3-4-5and 6 and lower 2/3 of C2 and upper third of C7 was done using the high speed drill. The epidural fat was absent at most of the levels. All compressing elements were eliminated.

Routine closure of the wound with smooth postoperative recovery.

Immediate recovery of the power of the three limbs.

Posterior decompression of the cervical spine in CCS seems to be more acceptable than the anterior approaches, using the new modifications with the high-speed drilling. By this method surgical trauma becoming to zero.

In the past, posterior decompression was associated with lot of complications due to surgical trauma by using the Smith-kerrisons and so on instrumentations.