Canadian C-Spine Rule (CCR)
Canadian C-Spine Rule (Stiell 2001): imaging is required if any high-risk factor is present, or if no low-risk factor allows safe range-of-motion testing, or if the patient cannot actively rotate the neck 45 degrees each way.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Any high-risk factor
- No
- Any low-risk factor permitting safe range-of-motion assessment
- Yes
- Able to actively rotate neck 45 degrees left and right
- Yes
Result: Imaging not required: low-risk factor present and able to rotate neck 45 degrees actively per Stiell 2001.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- high-risk factor
- Imaging recommended per Stiell 2001 step 1.
- no low-risk factor
- Imaging recommended per Stiell 2001 step 2.
- cannot rotate 45 degrees
- Imaging recommended per Stiell 2001 step 3.
- all three pass
- Imaging not required per Stiell 2001.
What you enter
- Any high-risk factor (age >= 65, dangerous mechanism, extremity paresthesias)
- Any low-risk factor permitting safe range-of-motion assessment
- Able to actively rotate neck 45 degrees left and right
How this is calculated
Stiell IG, Wells GA, Vandemheen KL, et al. The Canadian C-Spine Rule for radiography in alert and stable trauma patients. JAMA. 2001;286(15):1841-1848. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.