The patient  came to the clinic 13-March-2004 complaining of LBP with bilateral sciatica, more the left for 2 years, progressing. Cannot walk more than 500 meters with difficulty. MRI of the brain done 12-July-2003 showing mild brain atrophy, MRI lumbar showing bulge L5-S1, dorsal showing small syrinx at D7 and D8, cervical showing very huge extrusion C4-5 compressing the spinal cord.

On examination, the patient in pain, having neck pain when turning the head to all directions. There is severe weak grip and extension right hand 3/5 and right triceps muscle 3/5. The power of both lower limbs muscles 4/5. and hypalgesia below both knees.

The patient sent for investigations and MRI cervical spine done 05-May-2004 showing huge extruded disc C4-5 with severe spinal cord compression.

Using the C-arm, the level of C4-5 was identified and discectomy of C4-5 was performed and the extruded pieces inside the canal were removed until the dura was seen at the bottom of the removed disc cavity. Routine closure of the wound. Smooth postoperative recovery. The power of the right upper limb dramatically improved.

The patient came to the clinic 19-May-2004 with clean wound and the power of the upper limbs and right lower limb normalized. The power of the left lower limb still 4/5. The sensation recovered in the left lower limb.

The patient then came 16-August-2004 and the power of the left leg further improved and the sensation of the right lower limb further regressed.

The last time he came 17-May-2009 with MRI lumbar spine performed 03-May-2009 showing uneventful changes and he was treated conservatively.

The recurrence rate in cervical disc surgery is zero. Another disc can cause de novo extrusion.