Neurology Emergency Medicine Orthopaedics A

NEXUS Criteria for C-Spine Imaging

Five low-risk criteria to exclude cervical spine injury without imaging in blunt trauma. All five must be met to clear c-spine.

Score interpretation

C-Spine Can Be Cleared Clinically 0

All 5 NEXUS criteria met: C-spine injury risk <0.1%

→ C-spine imaging not required; can remove collar clinically; document NEXUS criteria in notes

C-Spine Imaging Required 1–5

One or more NEXUS criteria not met: C-spine injury cannot be excluded

→ Maintain in-line immobilisation; C-spine CT (preferred over X-ray); neurology/orthopaedics review if abnormality found

Interpretation bands for the NEXUS C-Spine. Apply clinical judgement and local guidance.

Hoffman JR, et al. 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.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.