The patient came to the clinic 18-August-2008 complaining of LBP for 6 months with left sciatica . MRI of the cervical spine performed 17-March-2008 showed very huge PCD C4-5 and C5-6 with malacia of the spinal cord at that level.

The patient using crutches for 4 months .

On examination: the defecation and micturition is normal. He has neck pain when bending to the right. Hypalgesia entire left upper limb and the right side of the body below D3 level. There is weak grip and flexion both hands 4/5 and both triceps  more weak the right -4/5. There is weak planterflexion both feet -4/5, and dorsiflexion both feet right -4/5, left 3/5. The right quadriceps femoris 3/4 and the left 4/5. There is bilateral Hoffmann  and Babinski  signs.

The patient was sent for new MRI of the cervical spine where the same findings were figured.

Discectomy of C4-5 and C5-6 was performed anteriorly guided with image-intensifier. The very huge extrusion of C4-5 was removed and the dura was seen at the C4-5 and C5-6 level.

Using Hybrid 2 level cervical miniplate  and 6 screws, anterior fixation of C4-5-6 was achieved. The bone dust harvested during surgery was returned back for bony fusion.

Routine closure of the wound and smooth postoperative recovery.

The patient had very huge disci which caused malacia of the spinal cord. After decompression the power of the four limbs normalized.