Canadian C-Spine Rule

Clinical cervical spine clearance (3 step). Reduces X-rays by approximately 40-50%; sensitivity ~99-100% for clinically significant injuries.

traumaspinal_clearanceA

Clinical cervical spine clearance without imaging

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STEP 1: Age ≥65 years*

STEP 1: Dangerous Mechanism (fall >1m, high speed, axial load, rollover, ejection)*

STEP 1: Paraesthesias in Limbs*

STEP 2: Simple rear-end collision (low speed, no rotation)*

STEP 2: Patient sitting or ambulatory after incident*

STEP 2: Delayed onset of neck pain (not immediate)*

STEP 2: No midline cervical tenderness*

STEP 3: Patient can actively rotate neck 45° left and right*

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