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🦴 NEXUS C-Spine Criteria

Clear the cervical spine clinically with the NEXUS low-risk criteria.

NEXUS C-Spine Criteria

Midline cervical tenderness
Focal neurological deficit
Altered level of alertness
Intoxication
Distracting painful injury

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

Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.

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