Background

A cautious outlook towards neck injuries is the norm to avoid missing cervical spine injuries. Consequently there has been an increased use of cervical spine radiography. The Canadian Cervical Spine rule was proposed to reduce the unnecessary use of cervical spine radiography in alert and stable patients. Our aim was to see whether applying the Canadian Cervical Spine rule reduced the need for cervical spine radiography without missing significant cervical spine injuries.

Background: A cautious outlook towards neck injuries has been the norm to avoid missing cervical spine injuries. Consequently there has been an increased use of cervical spine radiography. The Canadian Cervical Spine rule was proposed to reduce the unnecessary use of cervical spine radiography in alert and stable patients. Our aim was to see whether applying the Canadian Cervical Spine rule reduced the need for cervical spine radiography without missing significant cervical spine injuries.

Methods: This was a retrospective study conducted in 2 hospitals. 114 alert and stable patients who had cervical spine radiographs done for suspected neck injuries were included in the study. Data on patient demographics, Canadian Cervical Spine rule, cervical spine radiography results and further visits after discharge were recorded.

Results: 14 patients were included in the high risk category according to the Canadian Cervical Spine rule. 100 patients were assessed according to the low risk category. If the Canadian Cervical Spine rule was applied, there was a significant reduction in cervical spine radiographs (p< 0.001) as 86/100 patients (86%) in the low risk category would not have needed cervical spine radiograph. 2/100 patients who had significant cervical spine injuries would have been identified when the Canadian Cervical Spine rule was applied.

Conclusion: Applying the Canadian Cervical Spine rule for neck injuries in alert and stable patients reduced the use of cervical spine radiographs without missing out significant cervical spine injuries. This relates to reduction in radiation exposure to patients and cost benefits.