The patient was admitted to Shmaisani hospital 14-February-2010 complaining of neck pain for three years, increase the last 4 months with left shoulder and left upper limb pain associated with numbness of the fingers left hand.

MRI cervical spine performed 18-October-2007 showed small PCD C5-6 and C6-7 left side. MRI repeated 02-January-2010 showed huge extrusion of C5-6 compressing the left foramen  and old extrusion of C6-7 left side.

On examination: the patient is in agonizing pain and has weak grip, flexion left hand and left triceps muscle 3/5 and weak biceps 4/5. There is hypalgesia little finger left hand. There is severe pain with movement restriction of the neck in all directions.

Discectomy of C6-7 was done to remove the intradiscal material through minor hole to prevent future recurrence, Meticulous discectomy C5-6 was done and the extruded disc occluding the left foramen was removed. Using Prestige LP Medtronic  6X16 mm dimensions the artificial disc was inserted at C5-6 level and all the stages were checked using image-intensifier.

Routine closure of the wound.

Smooth postoperative recovery, with normalization of the power of the left upper limb with disappearance of dysesthesia of the same limb.

The indication for surgery was the PCD C5-6 and it was aided with Prestige LP Medtronic cervical system to improve the neurological outcome.

Using this moment, intradiscal cleaning of C6-7 was a good option to prevent future recurrence or escalation at this level.