SELECTIVE CERVICAL-SPINE RADIOGRAPHY IN BLUNT TRAUMA - METHODOLOGY OFTHE NATIONAL EMERGENCY X-RADIOGRAPHY UTILIZATION STUDY (NEXUS)

Fear of failure to identify cervical spine injury has led to extremely liberal use of radiography in patients with blunt trauma and remotely possible neck injury. A number of previous retrospective and small pr ospective studies have tried to address the question of whether any cl inical criteria can identify patients, from among this group, at suffi ciently low risk that cervical spine radiography is unnecessary. The N ational Emergency X-Radiography Utilization Study (NEXUS) is a very la rge, federally supported, multicenter, prospective study designed to d efine the sensitivity, for detecting significant cervical spine injury , of criteria previously shown to have high negative predictive value. Done at 23 different emergency departments across the United States a nd projected to enroll more than 20 times as many patients with cervic al spine injury than any previous study, NEXUS should be able to answe r definitively questions about the validity and reliability of clinica l criteria used as a preliminary screen for cervical spine injury.