Which criteria are used to determine clearance of cervical spine fractures without imaging?

• A. Ottawa spine rules
• B. Canadian C-spine rules
• C. Jefferson criteria
• D. Nexus criteria

Answer: (D)

The idea being tested is using a validated clinical decision rule to clear the cervical spine without imaging in trauma patients. The Nexus criteria are the specific rule for this purpose: if none of the five factors are present, you can safely clear the neck without radiographs. Those five factors are: no posterior midline cervical spine tenderness, no evidence of intoxication, a normal level of alertness, no focal neurological deficit, and no distracting injuries that could mask neck pain. If any one of these is present, imaging is warranted to rule out injury. The other options are different imaging guidelines (Ottawa spine rules, Canadian C-spine rules) or not standard criteria for clearance, so the Nexus criteria are the best fit for determining clearance without imaging.