Acute examination to rule out cervical spine injuries in adults

This paper provides a brief overview of current information and recommendations regard-ing acute imaging of adult patients to rule out cervical spine injuries. It summarizes the possibilities of plain X-ray examination of the cervical spine, which is technically demand-ing and has low diagnostic yield. Therefore, it is no longer recommended. Exceptions are locations where CT is not available and patients for whom exposure to medium or high doses of ionizing radiation is contraindicated. Routinely performed CT examinations of the cervical spine to rule out injury have a significant medical and financial impact. For this reason, internationally recognized criteria sets NEXUS (National Emergency X-Radiography Utilization Study) and CCR (Canadian C-spine Rule) have been introduced. These include information from the patient's history and clinical examination and are used to indicate the need for cervical spine CT to exclude trauma. Both systems are described and compared. According to some recommendations and in the opinion of the authors, combining the two systems could further improve their effectiveness.