Original Article

Impact of NEXUS Low-Risk Criteria on Cervical Injuries in a Turkish Tertiary-Care Hospital


  • Hasan Kavak
  • Nebi Surum
  • Erden Erol Unluer
  • Ersin Aksay
  • Abdurrahman Yilmaz
  • Burak Katipoglu

Received Date: 08.05.2017 Accepted Date: 31.07.2017 Eurasian J Emerg Med 2018;17(3):113-117


In the present study, we aimed to determine the amount of unnecessary X-ray graphics that could lead to cost-load and radiation side effects using NEXUS Low-Risk Criteria (NLC) that was applied and evaluated in patients with cervical spine trauma in the Izmir Ataturk Training and Research Hospital’s emergency department.

Materials and Methods:

Between June 2010 and September 2010, the trauma patients admitted to the emergency department were evaluated retrospectively. The age, sex, NLC, mechanisms of trauma, radiological imaging, cost, radiation load, and degree of cervical injuries were assessed.


In the present study, 1317 patients with a possible cervical spine injury were included. It was confirmed that the numbers of excluded and included patients according to NLC were 1014 and 303, respectively. In excluded patients, 479 (36.3%) did not have any radiology, but in 535 (52.7%) of them, unnecessary radiological imaging studies were administered. The trauma mechanism was crash at the same level in 310 (23.5%) of the total and 267 (26.3%) of the excluded patients. In addition, in-vehicle traffic accident was observed in 64 (21.1%) included patients. It was found that the number of cervical spine injuries was four in the excluded and 10 in the included groups, which was confirmed according to NLC.


The increase in the use of NLC leads to a decrease in both the cost and amount of radiation exposure in patients and health workers. In addition, the number of cancers due to iatrogenic etiologies in humans will be lower.