Background: Cervical spondylotic myelopathy (CSM) is a very common and devastating spinal disease. Congenital cervical stenosis (CCS) is the most common cause. We aimed to elucidate the security, effectivity, and feasibility of surgery combining laminoplasty with artificial disc replacement (ADR) to treat CSM patients with radiculopathy, especially for preserving the range of motion (ROM) of the cervical spine.Method: Between August 2008 and April 2019, 39 patients with multiple CSM caused by CCS were enrolled in the present study. All patients received laminoplasty first and then ADR. We used a retrospective collection of data for evaluating the functional and radiologic outcomes, especially regarding preservation of ROM.Results: Each patient underwent at least a 2-year postoperative follow-up. The Japanese Orthopedic Association score showed great improvements at 6 months. The ADR index-level ROM was preserved during follow-up. The subaxial Cobb angle could also be retained in the whole cervical spine, and the spinal canal diameter could be expanded by more than 52.6%. There were no severe complications or side effects, and no patients needed secondary surgery.Conclusions: We aimed to treat multiple levels of CSM with adequate decompression without too many intervertebral disc replacements. We were able to expand the spinal canal directly for these patients with CCS and needed only 1-or 2-level ADR to treat them with associated radiculopathy. This combined surgical strategy was secure, effective, and was able to preserve the ROM of the cervical spine.Level of Evidence: 4.

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Intradural spinal lipomas not associated with spinal dysraphism account are rare entity. The pure cervical intradural lipomas are rarer and only eleven cases have been reported in the literature. The median age at diagnosis was 35 (8m-52y) years old and the ratio of men to female was 1.4:1. The possible risk factor included weight increase or rapid metabolic change. Only one case had recurrent condition during follow-up period. Here, we reported a 32-year-old male who presented with posterior neck pain and radiating numbness from neck to bilateral upper extremities. The radiograph of cervical spine showed a widening spinal canal diameter. Further study confirmed a pure cervical intradural intramedullary lipoma without spinal dysraphism. For preventing the neurologic deficit, early diagnosis and adequately surgical decompression were needed. Subtotal removal with cavitational ultrasonic surgical aspirator has been widely use as it minimizes any traction on already compromised neural tissues.