颈椎滑脱与颈椎不稳

颈椎滑脱（cervical spondylolisthesis）是指椎体相对于下方椎体的滑移。通过测量椎体后缘滑移的距离，重度脊椎滑脱定义为水平平移>3.5mm，意味着不稳。

颈椎滑脱是颈椎不稳的结局，颈椎不稳因椎间盘和关节突关节退变或关节活动度多大如Ehlers-Danlos syndrome。

常规CT和MRI观察的都是静态的颈椎滑脱，需要前屈和后伸片来判断不稳（后缘滑移超3.5mm）。

滑脱的此节，如果有关节突关节积液、项韧带骨化、牵张骨赘等等往往也提示不稳因素。

中立位MRI显示椎管脊髓并无压迫，此时存在颈椎滑脱、甚至不稳时，在过伸和过屈时往往是有压迫。此类患者应该通过过伸或过屈位MRI捕获压迫图像。

影像学颈椎滑脱者有2/3是存在动态压迫，46%存在不稳。

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