Vertebral injury patterns in suicidal vs homicidal falls: A forensic and physical therapy collaborative framework

Abstract

The distinction between suicidal and homicidal falls is one of the most complex forensic pathology challenges. Vertebral trauma as an integral diagnostic marker in determining the intent of fatal falls is what the current paper investigates. Vertebral fracture patterns, related soft tissue damages, and correlation with the scene of occurrence are the areas of focus for the study in order to differentiate patterns that are characteristic of each type of death. Suicidal falls are largely defined by vertical axial compression fractures of the lower cervical and lumbar spine that are found in the absence of restraint or defensive trauma. In contrast, homicidal falls often exhibit non-uniform fracture distributions, upper cervical or mid-thoracic injuries, and associated peri¬¬mortem evidence like blunt-force trauma, strangulation marks, or limb restraint. Introduction of postmortem imaging, such as CT and radiographic examination, improves detection of faint vertebral and ligamentous trauma, providing more dependable biomechanical analysis. Comparative case analysis also confirms that correlation of vertebral injury with external and circumstantial evidence presents a valid foundation for differentiating self-inflicted from externally inflicted falls. The research stresses a multidisciplinary method—integrating anatomical, biomechanical, and contextual examination—to enhance the precision of forensic conclusions and facilitate judicial clarity in doubtful death cases.