Canadian C-spine Rule. And HOW does this relate to Cervicogenic Dizziness?

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The Canadian C-spine Rule is one of the most useful, reliable and valid differential decision making tools in our arsenal. As a very sensitive tool, it is a phenomenal screen for clinicians to rule out a cervical fracture. This is especially important prior to what rehabilitation clinicians do for a living—apply some type of local cervical treatment as it would obviously be an absolute contraindication to treatment.

Even if a PT is unable to fully cite the decision rule, most, if not all are aware of it and its purpose following a low or high trauma. How many of you would treat your MVA and/or concussion patient without having at least plain films performed by a physician? But there is one element that gets overlooked— and that is the ORDER of the various criteria that guide decision making.

As you can see from Figure 1 below, the clinician should NOT ask the patient to actively rotate the neck PRIOR to ruling out high risk factors and THENlow risk factors. There is a top-down approach, which makes the rule THE rule.