Canadian C-Spine Rule Reduces Imaging Rates Without Missing Fractures

More than 98% of cervical spine x-rays reveal no acute injuries. In a matched-pair cluster-randomized study, researchers evaluated the effect of an intervention for implementing the Canadian C-Spine Rule on rates of C-spine imaging at 12 emergency departments in Canada (6 university, 6 community). The intervention involved education, policy changes, and real-time reminders of the rule. Overall, 11,824 stable, alert adult patients (age range, 16–64) with blunt trauma to the head or neck were enrolled during the 12 months before and 12 months after the intervention.

According to the rule, patients with extremity paresthesias or dangerous mechanisms of injury (fall from more than 3 feet or 5 stairs, axial load to head, high-speed/rollover/eject…