Cervical Spine Clearance (Nexus Criteria)

Last updated 20.09.12





-  Exclusion of significant injury to cervical spine or cord in at risk patients



-  Patients should be in cervical collar as protection until cleared

-  Nexus Criteria used to exclude need for imaging

-  Cervical Spine X-rays +/- CT – C Spine

-  +/- MRI C – Spine



-  Head Injury


Nexus Criteria

-  Imaging required in at risk patients unless all criteria fulfilled

-  Criteria

-  Alert & lucid patient

-   GCS 15/15, no delerium..

-  No evidence of intoxication (EtOH..)

-   Recent known Hx of EtOH intoxication

-   Known Hx of other drug use with S/S

-  No posterior cervical midline pain or tenderness

-   Pain on palpation anywhere along nuchal ridge to T1 spinous process

-   Pain on direct palpation of C spine spinous process

-  No neurological defecit

-  No major distracting injury or major analgesia