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Ever wondered why some patients experience worsening instability after Chiari decompression surgery? In this video, Dr. Centeno reviews a case where a patient underwent an unsuccessful Chiari decompression that removed critical sub-occipital muscles, leading to destabilized craniocervical alignment and type 2b instability. Dr. Centeno explains how the removal of bone and muscles, such as the rectus capitis posterior minor and major, can dramatically alter the anatomy and emphasizes why a fusion or PICL procedure may be necessary afterward. 🔔 If you find this content helpful, please like, comment, and subscribe to stay informed. / @centenohome To schedule a telemedicine or in-person visit, call +1-303-429-6448 or email Isis at [email protected]. Dr. Centeno also answers questions on his Reddit thread at / picl Join him for weekly Facebook Lives at / centenoschultzclinic to learn more. Download Dr Centeno's book on craniocervical instability at https://centenoschultz.com/craniocerv... Join CCI Communities: PICL SubReddit: https://www.reddit.com/r/PICL/?rdt=58942 PICL Facebook Group: / ccjpicl Follow us for updates and news: Website: https://centenoschultz.com/ https://regenexx.com/ Facebook: / centenoschultzclinic Instagram: / centenoschultzclinic LinkedIn: / chris-centeno-m-d-b6838024 Centeno-Schultz Clinic 403 Summit Blvd Suite 201 Broomfield, CO 80021 303-429-6448 Key Timestamps: 00:00 – Introduction: Unsuccessful Chiari decompression case 00:21 – CT scan analysis: Altered skull and atlas alignment 00:40 – 3D image: Visualization of bone removal 01:07 – Discussion: Ongoing craniocervical instability and PICL fusion 01:18 – Warning: Loss of critical stabilizing muscles and patient unawareness