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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What our Patients Say

Joe and Christine Pecoraro write about their son Caleb, who underwent surgery with Dr. Greenfield for basilar invagination and Chiari malformation.

Our Care Team

  • Vice Chairman for Academic Affairs
  • Associate Professor of Neurological Surgery, Pediatric Neurosurgery
  • Associate Residency Director
Phone: 212-746-2363
  • Vice Chair for Clinical Research
  • David and Ursel Barnes Professor in Minimally Invasive Surgery
  • Professor of Neurosurgery, Neurology, and Otolaryngology
  • Director, Center for Epilepsy and Pituitary Surgery
  • Co-Director, Surgical Neuro-oncology
Phone: 212-746-5620
  • Assistant Professor of Neurological Surgery
Phone: 646-962-3388

Reviewed by Jeffrey Greenfield, Ph.D., M.D. 
Last reviewed/last updated: April 2021

Weill Cornell Medicine Brain & Spine Center 525 East 68 Street, Box 99 New York, NY 10065 Phone: 866-426-7787