When it comes to discovering and diagnosing cervical spine injuries, there are two commonly employed methods – the National Emergency X-Radiography Utilization Study and the Canadian C-spine rule. Typically, neither method is preferred over the other, as there has previously never been a distinct difference between the two processes; however, a study published in this month’s Canadian Medical Association Journal may have actually revealed that difference. According to the study’s authors – a team of physicians from Australia and the Netherlands – the Canadian C-spine rule offers a more accurate evaluation than the NEXUS.
Based on the study’s findings, the researchers were able to determine that the sensitivity of the C-spine rule ranged from 90 to 100 percent, while the NEXUS sensitivity only ranged from 83 to 100 percent. Additionally, the C-spine rule’s specificity ranged from 10 to 77 percent while the NEXUS specificity ranged from 2 to 46 percent. In order to determine these findings, the researchers used several medical searches to find articles that dealt with patients who experienced similar blunt trauma injuries that were diagnosed using both methods. Then, using Quality Assessment of Diagnostic Accuracy Studies criteria, they extracted specific data from each case to calculate the sensitivity and specificity.
Of their findings, the researchers wrote: “Based on studies with modest methodologic quality and only one direct comparison, we found that the Canadian C-spine rule appears to have better diagnostic accuracy than the NEXUS criteria. Future studies need to follow rigorous methodologic procedures to ensure that the findings are as free of bias as possible.”
The main difference between the two cervical spine injury tests isn’t very complicated. The NEXUS guidelines use symptoms and signs to determine the severity and magnitude of a spine injury, while the Canadian C-spine rule uses the mechanism of the injury to gauge the severity. The results of this study are beneficial to the entire process of diagnosing spine injuries in that they allow for greater confidence and education for both the patients and physicians. Additionally, when combined with imaging, the results could offer better insight into treatment.