patient is drowsy, respiratory difficulty power upper limb=2/5, lower limb=0/5,Bladder on catherer, BP=100/60mmHg, Chest-0(1)B/L ac(+), all reflex absent,(2) respiratory wheeze+, Seizure + on 03.03.09 c5 copperomy, c4c5 & c5-c6 desectomy + stobe reseen with cage & bone grafting for c4 to c6 done. Procedure done : cervical spine Fixation and tracheostomy Lower limb=0/2