Canadian C-Spine Rule

Determine whether cervical spine imaging can be safely avoided

The global unit selector only affects unanswered questions
1.Age?
2.Dangerous Mechanism?
3.Paresthesias in Extremities?
4.Simple Rear-end MVC?
5.Sitting position in ED?
6.Ambulatory At Any Time?
7.Delayed Onset of Neck Pain?
8.Absence of Midline C-Spine Tenderness?
9.Able to Actively Rotate Neck 45 degrees bilaterally?
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1. Age?

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About this Calculator

The Canadian C-Spine Rule should only be used using the original enrollment criteria. Enrolment criteria included stable trauma patients, GCS 15, Injury <48 hrs ago, Age >16 years, absence of known vertebral disease, absence of penetrating trauma, and not pregnant. A Sensitivity of 100% and a Specificity of 42.5% were demonstrated in the derivation study.

A comparison study between the NEXUS Criteria and the Canadian C-Spine Rule suggested that the NEXUS criteria are less sensitive (90.7 vs. 95-99%), though there remains some controversy over the results and methodology.

References

Stiell et al.

The Canadian C-Spine Rule for radiography in alert and stable trauma patients.

JAMA: the Journal of the American Medical Association 2001 October 17, 286 (15): 1841-8

Stiell et al.

The Canadian C-Spine Rule versus the NEXUS Low-Risk Criteria in Patients with trauma.

New England Journal of Medicine 2003 December 25, 349 (26): 2510-8

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