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NEXUS C-Spine Criteria

Determines which blunt trauma patients can have cervical spine imaging safely withheld — all five criteria must be negative to clear the C-spine.

C-spine clinically cleared
All 5 NEXUS criteria negative · 99.0% sensitivity for significant injury
Remove collar — no imaging required
0pts
Midline cervical tenderness
Focal neurologic deficit
Altered level of alertness
Intoxication
Distracting injury
Hoffman JR, et al. NEJM. 2000 · Head-to-head vs the Canadian C-Spine Rule: Stiell IG, et al. NEJM. 2003. Applies to blunt trauma at any age and any GCS. CT C-spine sensitivity ~98% vs ~52% for plain films.