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Cervical spine clearance in trauma patients is frequently guided by strict protocols, particularly when patients present with midline cervical tenderness or cannot be reliably examined. Although a normal CT scan is often used to justify cervical collar removal, subtle but clinically significant injuries may be missed. This case report describes a polytrauma patient with altered consciousness in whom a C5/C6 bilateral facet dislocation was initially overlooked on CT imaging. A retrospective review revealed a subtle avulsion fragment, which was indicative of the underlying injury. This case highlights the limitations of CT alone for cervical spine clearance. While the CT-based protocols may reduce healthcare costs and streamline patient management, they carry the risk of missing critical injuries. In high-risk patients, continued immobilisation and additional imaging, such as MRI, are essential to prevent potentially serious neurological complications.