Profile of spinal injuries in females and outcome on follow -up

Abstract

Background
Spinal cord injuries (SCI) in females are underrepresented in epidemiological literature, particularly in developing countries. Understanding gender-specific patterns is essential for targeted prevention and rehabilitation.


Objective
To profile spinal injuries in females presenting to a tertiary care neurosurgical Centre in Jammu & Kashmir, India, with emphasis on mechanism of injury, anatomical level, severity and functional outcomes, to help future studies in female spinal cord injuries as females behave differently due to anatomical, physiological, hormonal, their daily activities and cultural factors .


Methods

This observational study included all female patients with traumatic spinal injury presenting to Sher-i-Kashmir Institute of Medical Sciences between January 2020 and June 2025. Data on demographics, mechanism of injury, spinal level, severity (ASIA classification), prehospital care, and outcomes (SCIM III scores at discharge and follow-up) were analyzed. Statistical Analysis was done SPSS v 27.0. categorical variables were summarized as frequencies (%), continuous variables as mean +- SD. Chi- square and t-tests were applied, with significance at
p
 < 0.05.



Results
Sixty-eight female patients were included, most aged 40–60 years (35.3%). Falls from height (39.7%) were the leading cause, followed by motor vehicle accidents (16.2%) and falls from mountains (13.2%). Lumbar spine was most frequently involved (42.6%), followed by cervical (35.3%) and dorsal (22.1%) regions. Complete injuries predominated in cervical spine cases (50%), while most lumbar injuries were neurologically intact (62.1%). Only 4.4% received prehospital spinal immobilization. Mean SCIM III scores improved across all levels from admission to follow-up, with the greatest gains in lumbar injuries (44 to 63 in complete; 50 to 88 in incomplete injuries).


Conclusion
This is rare study which provides an important absolute overview of clinical profile and functional recovery patterns of female patients only with spinal injuries. Although many epidemiological characteristics are consistent with previously reported global trends, our findings highlight key female -specific factors such as fall related injuries of different types, different mechanisms of injuries for spinal level, higher vulnerability of lumber involvement and SCIM III score for follow up improvements, will help us to compare improvements in male groups when compared in future. Comparison will be possible with males when female specific data is present, this provides first step for further research in female spinal cord injuries which has been overshadowed by male data.