The patient came to the clinic 21-December-2017 complaining of neck pain and inability to walk for 2 years with progressive course  with exacerbation last 2 months. MRI cervical spine performed 02-July-2017 showing malacia of the spinal cord behind C3-4 down to C6-7 with PCD C3-4 and as be spondylolisthesis C3-4. The patient is a known diabetic for 2 years in treatment.

On examination, the patient is in wheelchair with hypalgesia below C3 The biceps right arm is -3/5, left side 4/5, flexion of the hands 3/5, extension both hands 2/5, triceps -3/5. The quadriceps femoris both lower limbs 3/5, dorsiflexion both feet 3/5. The planterflexion right foot 4/5 and left foot 5/5. Hoffmann positive both sides and Babinski too. SLRS in wheelchair 20 degrees both sides. There is loss of micturition control for 2 months. Edema both lower limbs.

The patient was sent for investigations. MRI cervical spine repeated 21-December-2017 showing the same data as before with stenosis at the 4 levels. Dynamic studies ruled out overmobility. CXR showed cardiomegaly. The patient was sent for cardio evaluation. Prescribed Ventor caused allergic edema. Hb was 10.3, ESR 50 mm/h, and uric acid 6.3 mg/dL.  

Decompressive laminectomy C3,4,5,6 and upper third of C7 was achieved without violating the extradural space. The dura became bulged and transparent. Routine closure of the wound.

Smooth postoperative recovery. The power of the four limbs with slight improvement. She was sent to the ward.

The clinical course is deteriorating. At least decompression will halt this deterioration.