Male 55 year daibetc known CSM operated 5 years by C5 C4 lamenectomy
Pre operative
Presented by progressive mylopathy
VAS neck pain 8
JOA score 9
Preoperative radiology
Canal stenosis adjacent segment disease reversed cervical kyphosis. Global sagittally imbalance
Operated by extended laminectomy C3 down to C6 augmented by lateral mass fixation with correct cervical sagittal balance
Post operative
VAS neck 2
JOA score 14
With excellent recovery
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4 Intraoperative positioning
