NEXUS (National Emergency X-Radiography Utilization Study) is a set of validated criteria used to decide which trauma patients do not require cervical spine imaging.
Trauma patients who do not require cervical spine imaging require all of the following:
- alert and stable
- no focal neurologic deficit
- no altered level of consciousness
- not intoxicated
- no midline spinal tenderness
- no distracting injury
The NEXUS criteria have a sensitivity of 99.6% for ruling out cervical spine injury in the original study validating the criteria (95% confidence interval, 98.6-100%) 2.
The NEXUS criteria may not be reliable with patient >65 years of age, however 4.
A commonly used mnemonic to remember the criteria is “NSAID”:
- Neurological deficit
- Spinal tenderness
- Altered mental status
- Intoxication
- Distracting injury
