Basilar invagination is an uncommon condition that occurs when the upper portion of the second vertebra (C2) moves upward. This may cause compression of the spinal cord and brainstem, creating a variety of neurologic problems, including sudden death.
Basilar invagination may:
Patients with minor symptoms due to basilar invagination can often be treated without surgery. They may undergo physical therapy, be prescribed non-steroidal anti-inflammatory medication, or wear a cervical collar.
Those with ongoing symptoms, however, may require surgery. This usually involves the removal of the bone causing the pressure.
If you need surgery, UPMC surgeons will use the Endoscopic Endonasal Approach (EEA) to treat basilar invagination. This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable areas.
EEA benefits include:
Those with basilar invagination may experience the following symptoms:
Symptoms of basilar invagination can become worse with flexion of the head, which even further drapes the brainstem and/or spinal cord over the upper portion of the second vertebra.
Doctors use imaging studies — such as head x-rays, CT, and MRI scans — to diagnose basilar invagination.
For basilar invagination that is not compressing the spinal cord may include non-surgical treatments such as:
This state-of-the-art, minimally invasive surgical procedure uses the nose as a natural corridor to reach these lesions, without any incisions in the face or head.
Most patients will subsequently need posterior cranio-cervical fusion to prevent recurrence and to stabilize the joints.