MSKOrthopaedics

Canadian C-Spine Rule for Cervical Spine Imaging

Determines need for cervical spine imaging after trauma in alert, stable adults (GCS 15). More specific than NEXUS criteria. Validated to reduce unnecessary C-spine imaging by 42%.

HIGH RISK: Age ≥ 65 years?

HIGH RISK: Dangerous mechanism? (fall ≥1 m or 5 stairs, axial load injury, high-speed MVA ≥100 km/h, rollover or ejection, bicycle or motorised recreational vehicle collision)

HIGH RISK: Paraesthesias in extremities (bilateral or in arms)?

LOW RISK: Any low-risk factor present? (simple rear-end MVC / was sitting in ED / ambulatory at any time / delayed onset neck pain / no midline cervical spine tenderness)

Unable to actively rotate neck 45° to left AND right?

Imaging Required

Canadian C-Spine Rule

C-spine imaging REQUIRED — No low-risk factor identified

Step 1 (High-risk): Negative. Step 2 (Low-risk): NEGATIVE — No low-risk factor present. Unable to proceed to mobility assessment. C-spine imaging required.

Reference: Stiell IG et al. JAMA 2001

Medical Disclaimer: This calculator is a clinical decision support tool for qualified healthcare professionals. It does not replace clinical judgement. Always interpret results in the full clinical context. Reference: Stiell IG et al. JAMA 2001.

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