🦴 NEXUS C-Spine Criteria
Clear the cervical spine clinically with the NEXUS low-risk criteria.
All five must be negative to clear clinically.
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When to use
Decide whether C-spine imaging can be safely avoided after trauma.
How it works
Imaging can be deferred only if all are absent: midline tenderness, focal neuro deficit, altered alertness, intoxication, and a distracting injury.
Key points
- All five must be negative to clear clinically.
- Highly sensitive for clinically significant injury.
- Canadian C-Spine Rule is an alternative with higher specificity.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Midline cervical tenderness | Absent |
|---|---|
| Focal neurological deficit | Absent |
| Altered level of alertness | Absent |
| Intoxication | Absent |
| Distracting painful injury | Absent |
→ImagingNo imaging needed
- Rule：If all five criteria are absent, the cervical spine can be cleared clinically.
| Midline cervical tenderness | Present |
|---|---|
| Focal neurological deficit | Present |
| Altered level of alertness | Present |
| Intoxication | Present |
| Distracting painful injury | Present |
→ImagingImaging indicated
- Rule：If all five criteria are absent, the cervical spine can be cleared clinically.
Frequently asked questions
- What is NEXUS C-Spine Criteria?
- Clear the cervical spine clinically with the NEXUS low-risk criteria.
- How is NEXUS C-Spine Criteria calculated? What is the core formula?
- Imaging can be deferred only if all are absent: midline tenderness, focal neuro deficit, altered alertness, intoxication, and a distracting injury.
- When is NEXUS C-Spine Criteria used?
- Decide whether C-spine imaging can be safely avoided after trauma.
- What are the key clinical points for NEXUS C-Spine Criteria?
- All five must be negative to clear clinically. Highly sensitive for clinically significant injury. Canadian C-Spine Rule is an alternative with higher specificity.
- What are the limits and cautions when using NEXUS C-Spine Criteria?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is NEXUS C-Spine Criteria calculated in practice? Can you show a worked example?
- Inputs: Midline cervical tenderness Absent, Focal neurological deficit Absent, Altered level of alertness Absent, Intoxication Absent, Distracting painful injury Absent → Result: Imaging No imaging needed（Rule: If all five criteria are absent, the cervical spine can be cleared clinically.） Inputs: Midline cervical tenderness Present, Focal neurological deficit Present, Altered level of alertness Present, Intoxication Present, Distracting painful injury Present → Result: Imaging Imaging indicated（Rule: If all five criteria are absent, the cervical spine can be cleared clinically.）