This report is of a 71-year-old woman who presented with a dropped head and difficulty in extending her neck. She was diagnosed with isolated neck extensor myopathy. Conservative treatment (use of a cervical collar and muscular strength training) temporarily improved her symptoms. However, destruction of cervical vertebrae and myelopathy progressed secondary to repeated microfractures from mechanical stress. The patient underwent 2-stage combined anterior and posterior decompression and fusion using autografts. At one-year follow-up, numbness of the bilateral upper limbs had resolved, and bone union was achieved. The patient was able to look straight ahead and was very satisfied with the outcome.