NEXUS C-Spine Rule is a validated clinical decision tool used to determine whether cervical spine imaging is necessary in trauma patients. It is commonly referenced alongside other orthopedic screening protocols such as the Canadian C-Spine Rule and Ottawa Rules.
To identify low-risk patients for cervical spine injury and reduce unnecessary imaging while maintaining diagnostic safety.
Imaging may be safely omitted if all of the following criteria are met:
No midline cervical spine tenderness
No evidence of intoxication
Normal level of alertness
No focal neurologic deficit
No painful distracting injuries
These criteria apply to alert, stable patients. If all five are satisfied, the likelihood of cervical spine injury is extremely low, supporting the decision to forego imaging. This approach minimizes radiation exposure and healthcare costs without compromising patient safety.
Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. N Engl J Med. 2000;343(2):94–99. doi:10.1056/NEJM200007133430203.