NEXUS — Cervical spine
Five low-risk conditions; no added rotation or numeric threshold.
NEXUS — Cervical spine
Principle
Blunt trauma with suspected cervical injury, clinically stable patient. Capsule limited to adults ≥18 years: local restriction, not an original NEXUS threshold. Outside use: penetrating trauma or nontraumatic indication. All five criteria must be assessable; alertness, intoxication and distracting pain require clinical judgement. A negative rule does not replace that judgement, particularly in older people.
Scope
Blunt trauma with suspected cervical injury, clinically stable patient. Capsule limited to adults ≥18 years: local restriction, not an original NEXUS threshold. Outside use: penetrating trauma or nontraumatic indication. All five criteria must be assessable; alertness, intoxication and distracting pain require clinical judgement. A negative rule does not replace that judgement, particularly in older people.
Interpretation limits
Blunt trauma with suspected cervical injury, clinically stable patient. Capsule limited to adults ≥18 years: local restriction, not an original NEXUS threshold. Outside use: penetrating trauma or nontraumatic indication. All five criteria must be assessable; alertness, intoxication and distracting pain require clinical judgement. A negative rule does not replace that judgement, particularly in older people.
Formula and logic
All five adverse criteria must be explicitly absent for a negative rule. At least one present: cervical injury cannot be excluded by NEXUS. An unknown criterion prevents a negative conclusion.
Interpretation
- Imaging not indicated by NEXUS
- All five low-risk conditions are met, subject to reliable context and examination.
- Cervical injury not excluded by NEXUS
- At least one low-risk condition is not met; assess the indication for imaging clinically.
Definition version : 0.1.0
Sources
- Hoffman et al. · New England Journal of Medicine — Validity of a set of clinical criteria to rule out injury to the cervical spine
2000-07-13 · Original text deposited by the author; methods and discussion read on 2026-10-06. Five low-risk criteria; no rotation, age65 or blood alcohol threshold added.