The patient came to the clinic 25-January-2011 complaining of numbness of the left upper limb for 2 months , then both upper limbs with shoulders.

MRI cervical spine performed 25-December-2010 showing PCD C4-5, 5-6 with malacia of the spinal cord at C4-5 level.

On examination: The patient  has pain when moving the head to all directions. There is severe weak grip and extension both hands -3/5 and the right biceps and both triceps 3/5 and right deltoid 4/5.  There is weak both lower limbs more the right 4/5 and hypalgesia of the entire upper and lower limbs left side.

Total discectomy C4-5 with removal of the extrusion and osteophytes compressing the spinal cord were removed. The dura was seen along the entire posterior aspect of the disc space. Intradiscal decompression of C5-6. Fidji cervical cage 14x17x6.1 mm was applied to C4-5. Another cage 12x17x4.5 mm was applied to C5-6  with Novabone. Trinica cervical plate 42 mm was used to achieve fusion with 6 screws 16x4.2 mm dimensions. All the stages of surgery were performed under image-intensifier.

Routine closure of the wound. Smooth postoperative recovery with improvement of the power of all limbs.

The spinal cord was suffering from C4-5 compression. All efforts were directed to that level. The other level was performed to achieve reduction of the alignment of the posteriorly pushed C5 body, to improve the curvature of the spine regionally.