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Basilar Invagination

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Diagnosing and Treating Basilar Invagination

A primary care doctor may suspect basilar invagination based on symptoms, but an MRI or CT scan is required to confirm the diagnosis. Flexion and extension views (dynamic imaging) are often helpful, but they should be done only under the supervision of a qualified surgeon or radiologist aware of the possible diagnosis.
Other testing may be crucial to determining how symptomatic the compression is, and if surgery may be helpful. These tests and evaluations include:

  • EMG (electromyography, which is a test of muscle health)
  • SSEP (Somatosensory Evoked Potential, which evaluates the sensory signals traveling from the body to the spinal cord and brain)
  • Polysomnography (sleep studies)
  • Swallowing evaluation
  • ENT evaluations


Nonsurgical options for treating basilar invagination are limited and include wearing cervical collar. For patients with severe spinal cord compression, or who are showing signs of neurological deficits, surgery is the best treatment option (see Surgery for Basilar Invagination).


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Reviewed by Jeffrey Greenfield, Ph.D., M.D. 
Last reviewed/last updated: August 2018