TY - JOUR
T1 - Paleopathological Features of the Cervical Spine in the Early Middle Ages
T2 - Natural History of Degenerative Diseases
AU - Weber, Jochen
AU - Czarnetzki, Alfred
AU - Spring, Axel
AU - Gerszten, Peter C.
AU - Goodrich, James T.
AU - Sonntag, Volker K.H.
AU - Benzel, Edward C.
PY - 2003/12
Y1 - 2003/12
N2 - OBJECTIVE: Trauma and degenerative joint disease are the most common pathological conditions observed in archaeological skeletal remains. We describe the prevalence of different types of cervical bone diseases observed in the early Middle Ages (6th to 8th centuries AD). METHODS: Human skeletons were excavated from Germanic row graves in southwestern Germany. One hundred ninety-six cervical spines thus obtained were examined for bone disease. The degenerative changes were classified into Grades 1 (marginal osteophytes), 2 (uneven joint surfaces), and 3 (osseous ankylosis). Cervical spinal canal stenosis was defined as anteroposterior diameters of <11 mm and intervertebral foraminal stenosis as <3.0 mm in the smallest diameter. RESULTS: Of the skeletons, 27.5% demonstrated degenerative changes of the cervical spine. The mean age of the skeletons at the time of death was 33.4 years, compared with 43.7 years for those with degenerative disease. Degenerative changes of the vertebral bodies (usually Grades 1 and 2) were most common in the C5-C6 (12.4%, P < 0.05) and C6-C7 (15.3%, P < 0.05) segments. 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 (P < 0.05), one-fourth of which demonstrated osseous ankylosis. We observed cervical spinal canal stenosis in 5 skeletons (2.6%) and osseous intervertebral foraminal stenoses in 12 (6.1%). Isolated cases of other pathological processes, i.e., spondylitis ankylopoietica, occipitalization of the atlas and axis, and an odontoid fracture with pseudoarthrosis, were also recorded. CONCLUSION: In the early Middle Ages, the prevalence of degenerative cervical spine disease was the same as that observed today. The C2-C3 facet joints demonstrated high rates of degenerative disease.
AB - OBJECTIVE: Trauma and degenerative joint disease are the most common pathological conditions observed in archaeological skeletal remains. We describe the prevalence of different types of cervical bone diseases observed in the early Middle Ages (6th to 8th centuries AD). METHODS: Human skeletons were excavated from Germanic row graves in southwestern Germany. One hundred ninety-six cervical spines thus obtained were examined for bone disease. The degenerative changes were classified into Grades 1 (marginal osteophytes), 2 (uneven joint surfaces), and 3 (osseous ankylosis). Cervical spinal canal stenosis was defined as anteroposterior diameters of <11 mm and intervertebral foraminal stenosis as <3.0 mm in the smallest diameter. RESULTS: Of the skeletons, 27.5% demonstrated degenerative changes of the cervical spine. The mean age of the skeletons at the time of death was 33.4 years, compared with 43.7 years for those with degenerative disease. Degenerative changes of the vertebral bodies (usually Grades 1 and 2) were most common in the C5-C6 (12.4%, P < 0.05) and C6-C7 (15.3%, P < 0.05) segments. 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 (P < 0.05), one-fourth of which demonstrated osseous ankylosis. We observed cervical spinal canal stenosis in 5 skeletons (2.6%) and osseous intervertebral foraminal stenoses in 12 (6.1%). Isolated cases of other pathological processes, i.e., spondylitis ankylopoietica, occipitalization of the atlas and axis, and an odontoid fracture with pseudoarthrosis, were also recorded. CONCLUSION: In the early Middle Ages, the prevalence of degenerative cervical spine disease was the same as that observed today. The C2-C3 facet joints demonstrated high rates of degenerative disease.
KW - Cervical spine
KW - Degenerative disease
KW - Paleopathology
UR - http://www.scopus.com/inward/record.url?scp=0344443357&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0344443357&partnerID=8YFLogxK
U2 - 10.1227/01.NEU.0000094951.54541.18
DO - 10.1227/01.NEU.0000094951.54541.18
M3 - Article
C2 - 14633309
AN - SCOPUS:0344443357
SN - 0148-396X
VL - 53
SP - 1418
EP - 1424
JO - Neurosurgery
JF - Neurosurgery
IS - 6
ER -
