Narrative review: NEXUS, Canadian C-Spine Rule, and CT in ED cervical spine clearance

CCR specificity ~45%, NEXUS ~37%; both ~99% sensitive for c-spine fracture in ED. CT >98% sensitive for bony injury, near-perfect NPV. MRI only for neuro deficit or SCIWORA. Narrative review.

• Narrative review without systematic search; summarizes evidence for NEXUS, CCR, CT, and MRI in blunt trauma.
• CT alone likely sufficient in obtunded patients with negative CT; routine MRI after normal CT is not cost-effective.
• Limitation: potential selection bias in cited studies, single-author narrative.

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