NEXUS Criteria | Cervical Spine Fracture / X-Ray Indication

Execution:

• If none of the following 5 risk factors are present, fractures of the cervical spine can be excluded and x-rays are not necessary:
  1. Focal Neurological Deficits
  2. Midline Spinal Tenderness
  3. Altered Level of Consciousness
  4. Intoxication
  5. Distracting Injury (which is another injury suffered that could distract from the neck fracture, e.g. femur fracture)

Study	Reliability	Sn	Sp	LR+	LR-
Michaleff et al. (2012)	NA	83-100	2-46	NA	NA
Ghelichkhani et al. (2020)	NA	83.2-97.7	48.2-56.3	1.8-2.2	0.05-0.3
Comment: NEXUS criteria seem to be less accurate than the C-Spine rules, but shorter and easier to apply.