Cervical spine injuries

Canadian C-Spine Rule (100% sensitive; 42.5% specific)

• "Age, Dangerous, Numb" → Radiography

  • Age ≥ 65 years;

  • Dangerous MOI: fall ≥3m or 5 stairs, axial load (diving), MVA (>100 km/hr, rollover/ejection, bike/bicycle);

  • NUMB: Numbness/tingling in UE/LE, Unable to rotate 45°, Midline tenderness, Before ambulation ± delayed neck pain

    • מיון אמבולטורי זה אחלה, שימוש בסמים/אלכוהול פחות (אין התייחסות במפורש!)

STEP 1 - Age, Dangerous, Numb
STEP 2 - r/o risk for ROM ✓ (minor MVA, sitting in the ER, ambulatory pts, delayed pain, ⊖ tenderness) 

STEP 3 - ✓ ROM

NEXUS low-risk criteria

• NSAID → risk for significant c-spine injury is low (לא קריטריון ROM ,לא שם דגש על המנגנון)

  • No pos. mid tenderness

  • No significant distracting injury

  • Alert & oriented

  • Intoxication absent

  • No neuro. deficit