Article
Paleopathological features of the spine in the early Middle Ages: Natural history of degenerative diseases
Paläopathologische Befunde der Wirbelsäule im frühen Mittelalter: natürlicher Verlauf von degenerativen Veränderungen
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Published: | April 23, 2004 |
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Outline
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Objective
Trauma and degenerative joint disease are the most common pathological conditions observed in archaeological skeletal remains. We describe the prevalence of degenerative spine bone diseases observed in the early Middle Ages (6th to 8th centuries AD).
Methods
This study was conducted on a sample of 253 skeletons from south-western Germany dating back in the early Middle Ages. The degenerative changes were classified into Grad 1 (marginal osteophytes), 2 (uneven joint surfaces), and 3 (osseous ankylosis).
Results
Degenerative changes were found in 27,5% of the cervical spine, 5,1% of the thoracic spine, and 24,3% of the lumbar spine. The mean age of the skeletons at the time of death was 34 years, compared with 44 years for those with degenerative disease. Degenerative changes of the vertebral bodies (usually Grades 1 and 2) were most common in C5-C6 (12,4%), C6-C7 (15,3%), L3-L4 (24,1%), L4-L5 (41,4%), and L5-S1 (26,4%). The medial (6,1%) and lateral (0,6%) atlantoaxial joints were rarely involved in degenerative disease. The facet joints from C3-C4 to C6-C7 demonstrated degenerative changes (usually Grades 1 and 2) in 8,0 to 11,8% of cases. The C2-C3 facet joints were significantly involved in degenerative disease in 19,7% of cases, one fourth of which demonstrated osseous ankylosis (Grade 3). We observed cervical spinal canal stenosis (defined as anteroposterior diameters of <11mm) in 2,6% at two levels (C6 and C7) and osseous intervertebral foraminal stenosis (defined as <3mm in the smallest diameter) in 6,1% (C4-C5 to C6-C7). There was no osseous lumbar spinal stenosis.
Conclusions
The prevalence of degenerative disease of the spine in specimens from the early Middle Ages was comparable to that in modern clinical studies of the same age group. The C2-C3 facet joints demonstrated high rates of degenerative disease.