The patient came to the clinic 28-August-2019 complaining of neck and left upper limb pain for 40 days with numbness index left hand. MRI cervical spine performed 09-July-2019 showing extruded disc C5-6 and C6-7 with left partial foraminal occlusion. On examination at that time, he had weak extension left hand 4/5. He had numbness of the left hand when turning the head up. The patient was treated conservatively. The patient then came 26-October-2019 telling that he was doing well until the last 4 days, when the same complain with more severe course took place. The patient has no diabetes mellitus, nor arterial hypertension.

On examination: the patient has weak extension left hand -4/5 with pain when turning the head up.

The patient was sent for investigations and MRI of the cervical spine performed the same day showing the same extrusion of C5-6, but the extrusion of C6-7 progressed in size with left upward migration.

Discectomy of C5-6, C6-7 was achieved and the left side of C5-6 and C6-7 was followed to achieve removal of the extruded pieces with osteophytectomy until the dura was seen and inspection of the roots to rule out any residual extrusion or compression. EOS cervical cages 14x17x6.5 filled with IN'OSS bone graft were inserted to both disc cavities. OSImplant cervical plate 44 mm length and 6 plate screws 4x16 mm ( 2 fixed and four variable) were used.  All stages were guided with C-arm. Routine closure of the wounds.

Smooth postoperative recovery. He was sent to the ward.

The patient progressed more severe pain after trail of conservative treatment and the disc of C6-7 progressed in size mandating surgical intervention.