Nature of Complaint: Patient was a 58 year old married female with significant degenerative disease in her vervical spine. She underwent surgery with hardware placement intended for level C3-C6. Intraoperative x-ray was used to confirm the operative levels. On the first post operative x-ray was apparent fixation was from C4-C7 rather than C3-C6. The patient was told of the missed level but was symptom free from the spinal compression symptoms. She had persistant neck pain attribute degenerative arthritis at C2-C3. She was taken back to surgery 20 months after the first surgery for fixation from C2-C7. The patient alleges the missed level at the time of the first surgery resulted in the need for a second surgery 20 months later.