The patient came to the clinic 26-December-2011 complaining of neck pain for 8 months and numbness of the left side of the body for 1 month, sudden onset and both lower limbs with ataxia. The patient is a known diabetic and had episode of right VI nerve paresis 2 months ago, which resolved within week. MRI of the brain done 19-November-2011 almost normal. MRI cervical spine showing severe cervical canal stenosis C3-4 and C5-6 with malacia of the spinal cord at these levels.

On examination, the patient has unstable stance with Romberg test falling to the left. There is weak biceps muscle, grip and extension of the hand 4/5. DTRs are exaggerated in the left with Hoffmann sign positive in both sides. DTRs are exaggerated in both lower limbs and Babinski positive in both sides. There is weak dorsiflexion left foot 4/5 with hypalgesia left L5 root.

In prone position, with slight flexion of the neck, decompressive laminectomy of C3-4-5 and C6 was done wide up to the border of the lateral masses. There was no epidural fat at these levels and after the decompression, the dura became wide and lax.

Routine closure of the wounds. Smooth postoperative recovery with improvement of the power of the left limbs.

The patient had cervical canal stenosis with the compressing elements from behind. In this case, posterior decompression is the logical solution of the problem.