Emergency & trauma

NEXUS cervical spine

Five clinical low-risk criteria after blunt cervical trauma.

Intended population: Adults after blunt trauma with concern for cervical spine injury. Pediatric and older-adult use needs additional caution.

All responses must reflect a clinician's verified history and examination. An unassessed finding is not an absent finding.
Persistent clinical concern, older age, or an unreliable examination may warrant imaging despite a negative rule. This rule does not clear thoracic or lumbar injury.

Age (years)

Blunt trauma (not penetrating trauma)?

Posterior midline cervical tenderness?

Focal neurologic deficit?

Abnormal level of alertness?

Evidence of intoxication?

Painful distracting injury?

Sources and scoring references

Original NEXUS validation study (2000) ↗

Implementation references reviewed October 28, 2026. Verify applicability and unusual or treatment-changing results against the linked references and local guidance.