![cervical spine x ray rules cervical spine x ray rules](https://3.bp.blogspot.com/-bsmUYRwxab0/UJaC1cvITII/AAAAAAAAAGs/rET-pEk4Vpc/s1600/cervical-spine-AP.jpg)
Many patients with trauma are suspected of having lesions of the cervical spine. Trauma is one of the main reasons for patient assessment in emergency departments.
![cervical spine x ray rules cervical spine x ray rules](https://www.saem.org/images/default-source/cdems/m3-curriculum/m3-fig-3-cervical-spine-lateral-lines.png)
An attempt to build an evidence-based algorithm has been made. The agreement between different guidelines and the evidence on which recommendations are based is low. We found complete agreement on one question, partial agreement for one questions, no agreement for two questions, while agreement was not assessable for 3 questions. The three selected guidelines were: NICE 2016, Eastern Association for the Surgery of Trauma 2009 and American Association of Neurological Surgeons and Congress of Neurological Surgeons 2013. In case of disagreement between the guidelines or if the quality of evidence appeared low, evidence from published systematic reviews on the topic was added to build an evidence-based algorithm for approach to spinal trauma in the ED. We compared the selected guidelines through seven a-priori defined questions. The three most relevant guidelines published on cervical spine trauma in the last 10 years were selected screening websites of the main scientific societies and through the comparison of a normalized Google Scholar and SCOPUS citation index.
![cervical spine x ray rules cervical spine x ray rules](https://www.ebmconsult.com/content/images/Xrays/Lateral_Cervical_Spine_Xray-over.png)
Aim of this study was to find areas of agreement and disagreement between guidelines, to identify topics in which further research is needed and to provide an evidence-based cervical spine trauma algorithm for ED physicians. High heterogeneity between different guidelines has been reported. Several guidelines on the evaluation of patients with suspected cervical spine trauma in the Emergency Department (ED) exist.