Background: Spinal extradural arachnoid cyst is extremely rare. The longest SEACs that have been reported in previous studies involved no more than 5 spinal segments. This study presents a case of SEAC diagnosed from T9 to L4 and excised through a novel laminectomy/laminoplasty. Case presentation: A 22-year-old female presented with a 5-year history of progressive paraparesis and numbness in both lower limbs. MRI revealed posterolateral epidural cystic mass extending from T9-L4 with a length of 190 mm and width of 15 mm. The cyst was totally removed through surgery. The patient's symptom was completely relieved 1 year after the surgery. There was no recurrence, compression on the spinal cord, or kyphotic deformity based on MRI and CT taken 1 year after. Conclusion: Spinal extradural arachnoid cysts are relatively uncommon but surgically curable causes of myelopathy. For symptomatic patients, early surgical intervention is suggested for restoring neurological functions. Performing laminectomy by using crainotome is safe and efficient.
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