Absence of the following criteria predicted a very low probability (near 100% sensitivity) of significant injury noted on c-spine x-rays (standard 3-view series) in a validation study using a series of 34,069 pts 1-101yo presenting to an ED with blunt neck trauma ("NEXUS" study, NEJM 343:94, 2000--JW):


The following clinical decision rule was found to have sensitivity of 100% and specificity of 42.5% for detection of "clinically important" acute C-spine injury in pts presenting with blunt trauma to head & neck, stable VS, and Glasgow Coma Scale score of 15, in a prospective cohort study of 8924 adults (mean age 37yo) (JAMA 286:1841, 2001--JW)