Sex Differences in the Spine

Purpose of ReviewThis paper aims to review anatomic and pathology-specific sex differences of the spine.Recent FindingsWhile cadaveric and imaging analyses have shown differences in planar orientation of vertebral anatomy and alignment, the data is less conclusive for clinically correlating these differences. Reports show that predilection to injury in athletes is influenced by both gender and the nature of the sport, which makes it difficult to determine the exact contribution of sex differences to injury rates. Multiple articles report an increased incidence of spondylolysis, disc degeneration, and ankylosing spondylitis in males and an increased incidence of scoliosis in females. There is no clear consensus regarding whether sex influences postoperative outcomes after spinal surgery.SummaryStudies pertaining to clinical manifestations of differences in spine anatomy and physiology have been predominantly inconclusive. While multiple reports show gender predilection for certain pathologic conditions and post-surgical outcomes, further studies are needed to determine gender differences in relation to the spine and its clinical relevance.