Which finding by itself mandates immobilization of the cervical spine?

• A. Midline cervical tenderness
• B. Inability to communicate
• C. Mechanism of injury
• D. Absence of neck pain

Answer: (A)

Midline cervical tenderness directly signals a possible injury to the cervical spine, such as a fracture or dislocation, and immobilization is the immediate protective response to prevent secondary spinal cord injury during movement or transport. This single finding is enough to justify immobilization because it indicates that the spine could be unstable even if other signs aren’t present yet. Inability to communicate raises concern for altered mental status or intoxication and may lead to immobilization as a precaution, but it’s not a direct sign of spinal injury on its own. Mechanism of injury informs risk level but isn’t proof of injury by itself, and the absence of neck pain argues against immobilization rather than supporting it.