Basilar Invagination
What is it?
Basilar Invagination is an uncommon condition in which the upper portion of the second cervical vertebra migrates upward and posteriorly into the intracranial space. Basilar invagination may be present at birth, occur as the result of an accident, or occur in people with bone diseases such as rheumatoid arthritis.
Symptoms
Patients generally become symptomatic when the displaced vertebral segment causes sufficient pressure on the upper spinal cord or lower portion of the brainstem. The most common symptoms include headache, dizziness, swallowing problems, numbness in the extremities, and paralysis. Symptoms can become worse with flexion of the head, which even further compress the spinal cord over the upper portion of C2.
Diagnosis
This condition is diagnosed by various imaging modalities such as plain x-rays, CT scans, and MRI.
Treatment
Treatment
Patients with minor symptoms due to basilar invagination can often be treated without surgery. They may undergo non-operative modalities such as physical therapy, non-steriodal anti-inflammatory medication, or a cervical collar. Surgical treatment is reserved for patients with symptoms refractory to non-operative management, neurological deficit, or severe spinal cord compression. Surgery usually involves the removal of bone that is causing the compression and stabilization using spinal instrumentation.