Surgery for basilar invagination involves the removal of bone that is causing the compression, and stabilization of the skull and spine using spinal instrumentation. (See before and after scans of a patient with basilar invagination in Pictures of Basilar Invagination.)
At the Weill Cornell Medicine Brain and Spine Center, we always use the least invasive surgical techniques possible for our patients. For basilar invagination, we frequently use a minimally invasive endonasal approach that doesn’t require opening the skull. A neurosurgeon uses an endoscope to maneuver through the nose to reach the odontoid, which allows removal of the odontoid bone at the top of the spine. This minimally invasive approach reduces risk and allows for faster recovery times.
Prior to removing the odontoid bone, the neurosurgeon will need to stabilize the spine through a minimal posterior fusion technique. It is not always necessary to do both surgeries.
Reviewed by Jeffrey Greenfield, Ph.D., M.D.
Last reviewed/last updated: April 2021