To be clinically cleared using the CCR, a patient must be alert (GCS 15), not intoxicated, and not have a distracting injury (eg, long bone fracture, large laceration). The patient can be clinically cleared providing the following:

The patient is not high risk (age >65 y or dangerous mechanism or paresthesias in extremities).
A low risk factor that allows safe assessment of range of motion exists. This includes simple rear end motor vehicle collision, seated position in the ED, ambulation at any time posttrauma, delayed onset of neck pain, and the absence of midline cervical spine tenderness.
The patient is able to actively rotate their neck 45 degrees left and right.

The NEXUS criteria state that a patient with suspected c-spine injury can be cleared providing the following:

No posterior midline cervical spine tenderness is present.
No evidence of intoxication is present.
The patient has a normal level of alertness.
No focal neurologic deficit is present.
The patient does not have a painful distracting injury
http://emedicine.medscape.com/article/824380-workup

..

despejar / aclarar / verificar / comprobar / confirmar que no se necesita estudios de imágenes / estudios radiológicos



NEXUS Criteria for C-Spine Imaging
******Clears patients from cervical spine fracture clinically, without imaging.******

The NEXUS Criteria were developed to help physicians determine whether cervical spine imagine could be safely avoided in appropriate patients.

Validation study included a prospective, observational sample of 34,069 patients, aged 1 to 101 years, presenting to 21 US trauma centers. 1.7% of those studied had clinically significant c-spine injuries (CSI). NEXUS Criteria found to have sensitivity of 99.6% for ruling out CSI (2/578).
Also detected 99.0% (8/818) of ALL c-spine injuries (6 of which were injuries that didn’t require stabilization or specialized treatment).
Adopting this rule could decrease imaging in the these patients by 12.6%.
Subsequent studies have found a sensitivity of 83-100% for CSI with majority finding 90-100% sensitivity.

Points to keep in mind

Unlike the Canadian C-spine Rule (CCR), NEXUS Criteria does not have age cut-offs and is theoretically applicable to all patients > 1 year of age. However, there is literature to suggest caution applying NEXUS to patients > 65 years of age, as the sensitivity may be as low as 66-84%.
In the only trial to undertake a prospective head to head comparison of NEXUS to the CCR, the CCR was found to have superior sensitivity (99.4 vs 90.7%). However the trial was performed by the creators of the CCR at hospitals that were involved in the initial CCR validation study. There were also post-hoc “clarifications” added by the authors to the original NEXUS Criteria, leading to some concerns about the generalizability of the study findings.
There is also debate about whether x-rays of the c-spine are sufficiently sensitive to rule out c-spine injuries in trauma patients and whether CT is a more appropriate imaging modality in this patient population.
http://www.mdcalc.com/nexus-criteria-for-c-spine-imaging/

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Note added at 23 mins (2015-12-08 13:40:14 GMT)
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So a sentence such as, "Cervical/TL spine should be cleared or stabilized" means it should be confirmed (via NEXUS or Canadian c-spine studies) that there is no cervical fractures (and no need for imaging studies) OR any injuries should be stabilized (with a collar, surgery, etc...)


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Note added at 26 mins (2015-12-08 13:42:38 GMT)
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The example below shows the use of "clear" to mean "confirm it is free from injury":

Canadian C-Spine Rule

Investigator: Ian Stiell

Summary: *******The cervical spine rule will permit physicians to standardize care of alert, stable trauma patients, to rapidly "clear" the cervical spine, and to be much more selective in the use of cervical spine radiography without jeopardizing patient care.**** Recently validated at nine Canadian sites and now the subject of a large CIHR-funded implementation study. The physician's dataform used in the validation study is available for review.
http://www.ohri.ca/emerg/cdr/cspine.html

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Note added at 5 days (2015-12-14 12:11:04 GMT) Post-grading
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FFS!