Spinal Motion Restriction is not required if ALL of the following are negative except for:

• A. Sixty-five (patient is ≥65 years)
• B. No spinal tenderness
• C. No altered LOC
• D. No distracting injury

Answer: (A)

The main idea is that some risk factors prompt spinal motion restriction even when a patient’s examination is normal. Being 65 or older is such a factor: age itself increases the likelihood of cervical spine injury or missed injuries, so immobilization is recommended despite negative findings on tenderness, mental status, or distracting injuries.

If there’s no spinal tenderness, the patient is alert with normal mental status, and there are no distracting injuries, those signs would generally indicate low risk and not require immobilization. However, age ≥65 overrides those reassuring signs because elderly patients have a higher risk of occult injuries, making immobilization the prudent choice.