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Spinal injury: assessment and initial management - NICE guideline

This guideline covers the assessment and early management of spinal column and spinal cord injury in pre-hospital settings (including ambulance services), emergency departments and major trauma centres.

Spinal injury: assessment and initial management covers traumatic injuries to the spine but does not cover spinal injury caused by a disease.It aims to reduce death and disability by improving the quality of emergency and urgent care. NHS England’s clinical reference group (CRG) produce the service specification for major trauma. The CRG intends to consider the NICE guidelines on major trauma, complex fractures, spinal injury and major trauma: service delivery in future updates to the service specification which are planned for 2017.

The guideline should be read alongside the NICE guidelines on major traumacomplex fracturesfractures and major trauma: service delivery.


This guideline includes recommendations on:

Who is it for?

  • Healthcare professionals and practitioners who provide care for people with suspected or confirmed spinal injury in pre-hospital and hospital settings
  • People with suspected spinal column or spinal cord injury secondary to a traumatic event, and their families and carers