What are the different types of basilar impression

There are two main types of basilar impression: primary and secondary. The primary type is most common. It is frequently associated with other vertebral defects, including atlanto-occipital fusion, odontoid abnormalities, Klippel-Feil anomaly, and hypoplasia of the atlas. Vertebral artery abnormalities may also be present. Secondary basilar impression arises as the result of softening of osseous structures at the base of the skull. Diseases associated with secondary basilar impression include osteomalacia, rickets, Paget's disease, osteogenesis imperfecta, renal osteodystrophy, and rheumatoid arthritis.


1. Anomalies associated with deformity and instability

• Klippel-Feil anomaly

2. Miscellaneous disorders

• Postlaminectomy kyphosis

• Neurofibromatosis

• Skeletal dysplasia (e.g. Larsen's syndrome)

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