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NEXUS criteria: cervical spine imaging

Trauma & imaging rules

Blunt trauma. A patient who meets all five low-risk criteria has a very low probability of cervical spine injury. Tick any criterion that is NOT met.

What you enter

  • Midline cervical tenderness
  • Focal neurological deficit
  • Altered alertness
  • Intoxication
  • Painful, distracting injury
FORMULALow probability only if: no midline cervical tenderness, no focal neurological deficit, normal alertness, no intoxication, no painful distracting injury
SourceHoffman JR et al. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. NEJM 2000;343:94-9NoteSensitivity 99.0% for any cervical spine injury, specificity 12.9%, in the NEJM 2000 cohort.ReviewedFormula and thresholds checked against the source on 2026-09-28. If the source updates, this line will say so.