Cervical Spine Pathology in the Context of Intimate Partner and Interpersonal Violence: A Case Series and Focused...

Intimate partner violence (IPV), interpersonal violence, and caregiver abuse are common, frequently under-disclosed contexts for neurotrauma and delayed injury recognition. Relative to traumatic brain injury and hypoxic/anoxic injury after nonfatal strangulation, IPV-associated spinal injury is less well characterized, and existing spine literature has largely emphasized thoracolumbar compression-type fractures rather than cervical spine injuries. We present three neurosurgical cases of cervical spine pathology with cord or nerve root compromise occurring in the context of disclosed IPV or suspected interpersonal violence/caregiver abuse, representing acute, subacute, and chronic presentations Imaging phenotypes included C5-C6 left paracentral/foraminal disc herniation with canal/foraminal compromise, multilevel cervical stenosis with cord compression and myelomalacia, and a destructive C6-C7 disc-space process with cord compression followed by instrumentation failure after recurrent trauma. The cases illustrate delayed or partial disclosure, dependence on caregivers or partners, incomplete neurological documentation, psychosocial vulnerability, and missed opportunities for safety intervention when disclosure is not elicited in a private and trusted setting. All three patients disclosed nonfatal strangulation or assault-related neck trauma, highlighting the relevance of strangulation screening and selective vascular, brain, and cervical spine imaging in neurotrauma and spine settings. We synthesize literature on IPV-related neurotrauma, spinal injury patterns, disclosure, strangulation evaluation, and emerging blood-based biomarkers, and propose a pragmatic "neurosurgical touchpoint" pathway for privacy-enabled screening, objective documentation, safe provision of supports, selective imaging, and warm referral to social work/IPV advocacy resources. Neurosurgical encounters may therefore represent critical opportunities to identify risk, support safe disclosure, and reduce missed opportunities for intervention.