I agree spinal fusion must be a last resort. I did not resort to that lightly. I managed instability with NUCCA /Atlas Orthagonal corrections for over 3-4 yrs, but that stopped working & I now realise I had some iHH all that time.
But if you have the right spinal fusion surgeon, it’s probably 2 months of significant discomfort and pain for a potentially permanent relief of Brain stem being squeezed by Atlas bone, disruption of cFS fluid flow in spine/brain& relief of muscular distortion . My neurosurgeon never fuses below C1/C2.
For me -as I had VES, JV compression x2, the increased blood flow from fusion was difficult. My recent VES ENT surgery to skull base on right side has made a big difference at week 5-6. May Not be out of woods yet, but a lot better than 12 months ago.
Just sharing in case it helps those fit whom fusion becomes the only viable option. D