/NEXUS Cervical Spine Rule

NEXUS Cervical Spine Rule

Clears C-spine without imaging

Total Score

0

Low risk. Cervical spine imaging is not necessary.

00Low
15High

Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.

Yasal Uyarı: Bu platformdaki klinik skorlamalar ve algoritmalar yalnızca sağlık profesyonellerini bilgilendirme amaçlıdır. Herhangi bir kesin tıbbi teşhis, tedavi veya klinik karar yerine geçemez. Nihai karar ve sorumluluk hastayı yatak başında değerlendiren hekime aittir.

Clinical Overview

The NEXUS (National Emergency X-Radiography Utilization Study) criteria is a validated clinical decision rule used to determine the necessity of cervical spine imaging following blunt trauma. If all five criteria are negative, the probability of a clinically significant cervical fracture is extremely low (99.8% negative predictive value).

Clinical Pearl

The 'Distracting Injury' criterion is the most subjective. If a patient has a femur fracture or severe burn, they may not perceive neck pain. Always image these patients. Additionally, 'intoxication' applies to any agent impairing cooperation, not just alcohol.

Pitfalls & Warnings

  • In elderly patients (>65), the Canadian C-Spine rule is often preferred due to the risk of osteoporotic fractures from low-energy trauma.
  • Cannot be applied if the patient is intubated or sedated.

Academic References

Hoffman JR, Mower WR, Wolfson AB, et al. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med. 2000;343(2):94-99.

Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.