The patient came to the clinic 01-June-2014 complaining of weak four limbs for 9 months with inability to walk the last 4 months. MRI cervical spine done 03-February-2014 showing severe cervical canal stenosis C2-3, 3-4, 4-5, 5-6 and C6-7. MRI lumbar spine done 08-June-2013 showing old extruded disc L4-5 and L2-3. The patient is diabetic and has arterial hypertension for 2 years in treatment and taking Baby aspirin. The patient underwent laminectomy of L4-5 done 2 years ago at Islamic hospital - Amman.

On examination; The patient in wheelchair. He has difficult micturition for 3 months. He cannot grip both hands and the biceps both upper limbs 3/5. He cannot extend the right hand and there are elements of extension of the left hand 1/5.The right triceps muscle power 3/5, the left 4/5. The power of dorsiflexion both feet -3/5 and planterflexion -4/5. There is hypalgesia of the left C3,4,5,6,7,8 roots territories and below the right C4 down to include the right lower limb. There is profound atrophy of both interossii muscles both hands. Babinski was positive in both sides and clonus of the right side.

The patient was sent for dynamic cervical X-ray which ruled out presence of any instability. The patient was sent for cardio consultation and Aspirin stopped for 5 days before surgery.

In supine position with Hallo traction 7 Kg, decompressive laminectomy C3,4,5,,6 with lower third of C2 and upper third of C7. The dura was transparent and after the decompression expanded dramatically. Routine closure of the wound.

Smooth postoperative recovery. The power of the four limbs still the same.

The patient immediately before surgery got slight improvement of the four limbs because, Somazina and Nucleo-CMP were started the moment of his visit and they will be continued for 12 months at least.