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Canadian C-Spine Rule

Imaging decision rule for alert, stable trauma patients.

Last reviewed January 6, 2026
years

Dangerous mechanism

Fall >3 ft/5 stairs, axial load, high-speed MVC, rollover/ejection, motorized recreational, bicycle collision.

Paresthesias in extremities

Simple rear-end MVC

Sitting position in ED

Ambulatory at any time

Delayed onset of neck pain

No midline cervical tenderness

Able to actively rotate neck 45 deg left and right

Assess only after excluding every high-risk factor and confirming a low-risk factor permits safe assessment. Do not force movement; select Not assessed if unsafe or not indicated.

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References