The purpose of our (Dys)functional Friday posts is to inform you about a variety of disorders in the body. These disorders or dysfunctions can be acquired, or we can be born with them. Educating ourselves about these disorders will help us move more sustainably by acquiring a general understanding of what is happening in the body structurally, the symptoms that may be warnings signs for worsening conditions, and ways we can prevent, maintain, or improve these dysfunctions. Over the next couple of weeks, we will be learning about a few of the cervical disorders I had listed in the previous week’s blog post. Today, we are looking at Basilar Invagination.
A Little About the Structures Involved
The brain is protected by the bones of the skull, while the spine is protected by the bones of the spinal column. The brain stem is a part of the brain that emerges from its base. It is long and roughly cylindrical–like a stem–and it provides the connection between brain and spinal cord. It leaves the skull through a circular opening in the skull base called the foramen magnum. The brain stem then connects with the spinal cord, which travels down the spinal column in the neck (and beyond).
The spine in the neck is called the cervical spine. The individual bones of the cervical spine, called vertebrae, are named according to a simple pattern. The names all start with the letter “C” for cervical, followed by a number that indicates their position. C1 is at the very top of the spine, just below the skull. C1 supports the weight of the skull. C2, the second vertebra, is underneath C1.
The joint between C1 and C2 is unusual–it allows much more movement than any other spinal joint. This is the joint that allows the head to turn, rotate and nod. One special feature of this joint is a peg of bone, about the size of the tip of a pinky finger, that sticks up from the front of C2 and fits into a groove in C1. It’s called the dens, or odontoid process.
So, What is Basilar Invagination?
In basilar invagination, C2 and the dens move out of alignment: back and up, toward the foramen magnum. In this position, the dens may compress the brainstem and/or the top of the spinal cord.
What are the symptoms?
Symptoms may include headache, dizziness, confusion, trouble swallowing, weakness, numbness, and electric-like tingling when the neck is bent. Symptoms usually become worse when the neck is bent, as this position pulls the spinal cord over the projection of the dens.
People with minor symptoms due to basilar invagination may undergo physical therapy, be prescribed non-steroidal anti-inflammatory medication, or wear a cervical collar. Those with ongoing symptoms, however, may require surgery.
More specifically if the joint is fixed or fused, Foramen Magnum decompression was identified to be the treatment for basilar invagination. Whereas, if the joint is not fixed or fused stabilization is recommended as instability is the cause of basilar invagination.
By having a better understanding of these disorders, their causes, symptoms, and treatments, I am hoping we can develop some preventative self-care habits that will help you move more sustainably. See you here next week for another (Dys)function discussion! Thanks for stopping by!