Purpose: The Canadian Cervical Spine Rules were developed in order to determine the need for radiographs after acute head/neck injury secondary to the risk of fracture.
Stage of CPR Development: Validated.
High Risk Factors Present?
1. Age > 65
2. Dangerous Mechanism of Injury (i.e. fall > 1m or 5 stairs, axial load to head, high-speed motor vehicle accident, motorized recreational vehicle, bicycle collision)
3. Paresthesias in extremities
Low Risk Factors that allow safe assessment of range of motion?
1. Simple rear-end motor accident
2. Normal sitting posture in emergency department
3. Ambulatory at any time since injury
4. Delayed onset of neck pain and absence of midline tenderness
Is the patient able to actively rotate the neck > 45 degrees to the right and the left?
If there is (1) High Risk Factors or (2) Low Risk Factors and the inability to actively rotate the neck > 45 degrees to the right and the left, radiographs are indicated.
|Stiell et al., 2001||1.00||0.43||1.74||0.01|
|Stiell et al., 2003||0.99||0.45||1.81||0.01|
|Miller et al., 2006||1.00||0.51||1.80||0.24|
|Rethnam et al., 2008||1.00||0.77||3.55||0.22|
|Stiell et al., 2009||1.00||N/A||N/A||N/A|
|Vaillancourt et al., 2009||1.00||0.38||1.55||0.10|
|Coffey et al., 2010||1.00||0.42||1.63||0.13|
|Stiell et al., 2010||0.90||0.44||1.61||0.22|
|Duane et al., 2011||1.00||0.01||1.00||0.42|