Copyright 2002 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.2002
To the Editor: Dr Stiell and colleagues1 developed the Canadian C-Spine Rule to reduce the
use of unnecessary C-spine radiography in alert, stable patients who might
have a C-spine injury. However, 3 limitations of the study will limit application
of the rule. First, the authors repeatedly cite a "dangerous mechanism of
injury" as one of the criteria of patients at "high risk" for C-spine injury,
yet do not define "dangerous mechanisms." The lack of definition makes this
criterion open to wide interpretation. Similarly, the authors state that "our
data clearly demonstrate that particular mechanisms of injury are associated
with substantially increased risk of important injury," but fail to identify
Harris, Jr JH. Decisions About Cervical Spine Radiography Following Trauma. JAMA. 2002;287(5):583–584. doi:10.1001/jama.287.5.583
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