Cervical spine injury
Redirect page
Redirect to:
📊 NEXUS Criteria Calculator [show]
NEXUS Criteria
| Criteria (ALL must be absent to clear) | Absent | Present |
|---|---|---|
| Posterior midline cervical tenderness | 1 | |
| Focal neurologic deficit | 1 | |
| Altered level of alertness | 1 | |
| Intoxication | 1 | |
| Distracting painful injury | 1 | |
| Criteria Present | / 5 | |
| Interpretation | |
|---|---|
| 0 | C-spine can be cleared clinically — All 5 criteria absent. No imaging needed. Sensitivity 99.6% for clinically significant injury. |
| ≥1 | Cannot clear clinically — C-spine imaging indicated. |
| References |
|---|
|
📊 Canadian C-Spine Rule Calculator [show]
Canadian C-Spine Rule
| Step 1: Any High-Risk Factor? (mandates radiography) | ||
|---|---|---|
| Criteria | No | Yes |
| Age ≥65 | 1 | |
| Dangerous mechanism (fall ≥1m/5 stairs, axial load to head, MVC >100km/h or rollover/ejection, motorized recreational vehicle, bicycle collision) | 1 | |
| Paresthesias in extremities | 1 | |
| Step 2: Any Low-Risk Factor? (allows safe ROM assessment) | ||
| Simple rear-end MVC (excludes: pushed into traffic, hit by bus/large truck, rollover, hit by high-speed vehicle) | 1 | |
| Sitting position in ED | 1 | |
| Ambulatory at any time since injury | 1 | |
| Delayed onset of neck pain (not immediate) | 1 | |
| Absence of midline cervical tenderness | 1 | |
| Step 3: Able to actively rotate neck 45° left and right? | ||
| Can rotate neck 45° L and R | 1 | |
| High Risk Factors | / 3 | |
| Low Risk Factors | / 5 | |
| Interpretation (stepwise) | |
|---|---|
| High risk ≥1 | Radiography indicated — Do NOT assess ROM. Image the c-spine. |
| Low risk = 0 | Cannot assess ROM safely — No low-risk factor present to allow safe assessment. Image. |
| Low risk ≥1 + ROM OK | C-spine can be cleared — At least one low-risk factor AND able to rotate neck 45°. No imaging needed. |
| Low risk ≥1 + no ROM | Radiography indicated — Low-risk factor present but unable to rotate. Image. |
| References |
|---|
|