Basilar invagination: craniocervical instability treated with cervical traction and occipitocervical fixation. Case report

J Neurosurg Spine. 2007 Oct;7(4):444-9. doi: 10.3171/SPI-07/10/444.


The upward odontoid displacement observed in basilar invagination (BI) is generally associated with a horizontal clivus and craniocervical kyphosis, conditions that exert ventral compression at the spinomedullary junction. Ventral brainstem decompression by reduction or elimination of the odontoid invagination is part of the desired treatment. The authors describe a case of BI in an adult, who was effectively treated with the easy and safe reduction of odontoid invagination via cervical traction. Normalization of kyphosis at the craniovertebral junction and the vertical position of both a previously horizontal clivus and the cerebellar tentorium demonstrated that these conditions were not part of the original malformation but instead were caused by a reducible craniovertebral instability.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Atlanto-Occipital Joint*
  • Humans
  • Joint Instability / complications*
  • Joint Instability / diagnostic imaging
  • Joint Instability / surgery*
  • Male
  • Platybasia / diagnostic imaging
  • Platybasia / etiology
  • Platybasia / therapy*
  • Radiography
  • Spinal Fusion*
  • Traction*