NEXUS Criteria for C-spine Injury

N.E.X.U.S. = National Emergency X-ray Utilization Study

Utility:  if criteria fulfilled, low risk for spinal injury and c-spine can be cleared without the need for imaging

NEXUS Criteria:

  • Normal level of alertness
  • Not intoxicated
  • No midline cervical spine tenderness
  • No other painful injuries that may distract the patient from a less painful (but broken) neck
  • No focal neurologic deficits

Only if patient fulfills all 5 criteria – then forego imaging.  Otherwise, proceed with imaging.

Mnemonic: NSAID (neuro deficit, spinal tenderness, AMS, intoxication, distracting injury)

National Emergency X Radiography Utilization Study NEXUS Criteria Emergency Medicine Practice.JPG



Hoffman, Jerome R et al. “Selective Cervical Spine Radiography In Blunt Trauma: Methodology Of The National Emergency X-Radiography Utilization Study (NEXUS)”. Annals of Emergency Medicine 32.4 (1998): 461-469. Web.


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