Tandem spinal stenosis is a clinical phenomenon which is mostly due to degenerative changes in an individual. Most patients present with neck and low back pain with neurological deficits of varying degrees. It is a condition that commonly occurs in individuals greater than 55 years of age. Cervical compressive myelopathy is the most common condition associated with tandem spondylosis. We present the first documented combined anterior and posterior (360 degree) cervical decompression surgery done on account of tandem spinal stenosis in south western Nigeria. A 65-year-old man who presented with severe neck and low back pain and progressive quadriparesis secondary to cervical compressive myelopathy with associated Tandem spinal stenosis. He subsequently had a combined anteriorposterior (360 degrees) cervical decompression and fusion with titanium plate and screws. An iliac crest (tri-cortical) bone graft was used. There was gradual resolution of both neurological deficit and pain noted by the patient after the above surgery was done.