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Abstract Background The vertebral column has been used in forensic studies for its weight-bearing function and relative density. Sex estimation is one of the essential elements in an anthropological examination, as it may narrow down the possibility of a match by half. Hence, it is crucial to derive the population-specific reference data in each vertebra for sex estimation. This systematic review explored the most sexually dimorphic vertebra by using the conventional anthropometric analysis. Main body An electronic comprehensive search was conducted using databases such as Scopus, Web of Science (WOS) and EBSCO Medline for relevant studies between 2008 and 2020. The main inclusion criteria were studies in English, and studies on sex estimation by morphometric analysis of vertebra by CT scan or dry bone. Only studies related to human adult age and vertebra were analysed. Literature search identified 84 potentially relevant articles, in which 19 articles had fulfilled the inclusion criteria. This review included studies on the cervical, thoracic and lumbar vertebrae in different populations. Conclusion The vertebral spine has demonstrated significant sexual dimorphism with variable prediction accuracies, whereby the body of a vertebra was found to be sexually dimorphic. It was shown that high accuracy of sex classification was provided by the second cervical, twelfth thoracic and first lumbar vertebrae, especially when they were used in combination.
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