• 78-year-old lady right-handed physician who presented with progressive loss of manual dexterity and weakness of left hand with inability to button hershirt. She also complained of stiffness in her legs.
  
  
• Her neurological examination showed normal strength, but numbness in the thumb and index finger on both sides. She also had brisk reflexes and positive Hoffman’s sign.

MRI scan of the patient's cervical spine (neck) shows stenosis (narrowing) at C4-C5 and C5-C6 with spinal cord compression. There is spinal cord contusion at C4-C5.

• After a comprehensive work-up and eliminating other potential contributing causes of her disease, and an appropriate period of conservative measures, she underwent anterior cervical discectomy and instrumented fusion (ACDF) at C4-C5, and C5-C6 with spinal cord decompression.

• She did well postoperatively with significant improvement in her spasticity, and manual dexterity and strength. She was pain free.