Information for the public
Assessment at the hospital
Once the person arrives at the hospital they should be assessed again (see assessment at the scene). This will be similar to the assessment carried out at the scene, but it may vary depending on their injuries. If staff at the hospital think there might be an injury to the spine, the person should be offered a scan to confirm this.
X-rays and scans
The type of scan the person has will depend on which part of the spine is injured, based on the assessments, and whether the person is a child or an adult. All scans should be done urgently.
Upper spine
If the person is 16 or over and their healthcare team thinks it's very likely they have an injury to their upper spine (called the cervical spine), they should have a type of scan called a CT scan to give a detailed picture of this area. If the CT scan shows that the spinal cord might be injured, an MRI scan may be needed to confirm this.
Children under 16 should have an MRI scan if their healthcare team thinks it's very likely that their upper spine is injured. But if it is less likely, they might have an X‑ray if their healthcare team still has concerns. CT scans aren't used as often in children (under 16s) because of concerns about radiation from the scan and its effects in children.
If the person (adult or child) has had a head injury, they may also need to have their head scanned to check for any damage. See other NICE guidance for more information about head injury.
Lower spine
If the person is 16 or over and their healthcare team thinks it's very likely that they have an injury to their lower spine (called the thoracic or lumbosacral spine), they should have a CT scan. If the CT scan shows that the spinal cord might be injured, an MRI scan may be needed to confirm this.
If it's less likely that the person (adult or child) has injured their lower spine, they should have an X‑ray. Depending on the results of the X‑ray, they might need to have a CT scan if more information is needed.
Whole body
If the healthcare team thinks the person might have injuries to other parts of their body – for example, if the person has been injured in a major car accident – they might need to have a CT scan of their whole body to check for any damage. However, children should only have the parts of the body scanned where damage is suspected, to reduce the amount of radiation they have.