Table 2.

Congress of Neurological Surgeons recommendations

Semeiotics	Imaging
Awake and asymptomatic not complaining of neck pain or tenderness, with a normal neurological examination and a complete functional range of motion at a physical examination	Radiographic evaluation of the cervical spine is not recommended and discontinuance of cervical immobilization is possible (Level I recommendation) [26]
Awake and symptomatic	High-quality computed tomography (CT) imaging is recommended If high-quality CT imaging is not available, 3 CS projections (anteroposterior, lateral, and odontoid) are recommended. Moreover, if necessary to define or better visualize suspicious areas, a CT is recommended, as soon as available (Level I recommendation) [26]
Obtunded or unevaluable	High-quality CT imaging is recommended as the initial imaging technique of choice If high-quality CT imaging is not available, 3 CS projections (anteroposterior, lateral, and odontoid) are recommended. Moreover, if necessary to define or better visualize suspicious areas, a CT is recommended, as soon as available (Level I recommendation) [26]