184 • Eugen Strouhal 



Figure 5. Case no. 1. Deformity covered by ossified left 

 lateral longitudinal ligament, encompassing 10th costover- 

 tebral joint. 



ossification of the interspinal ligament. The intervertebral 

 space T8-9 was preserved (height 2 mm) and there was also a 

 wavy chink dividing the ossified left lateral longitudinal liga- 

 ment. The right side of the body of T8 was bare. 



Intervertebral openings and the spinal canal did not show 

 any reduction that could have caused neurological problems. 



The course of the vertebral column was deformed both in 

 the frontal and sagittal planes. There was a slight, S-shaped 

 scoliosis, sinistroconvex in the lumbar and lower thoracic 

 sections, dextroconvex in the upper thoracic half. 



The kyphotic angulation reaching 1 30° appeared more im- 

 portant. To compensate for this protuberance, the remaining, 

 healthy lumbar vertebrae showed increased anterior heights 

 compared with their posterior heights (L2 36/26, L3 34/30, 

 L4 32/28, L5 32/26 mm). At the same time, the physiologi- 

 cal thoracic kyphosis was reversed into a compensatory lor- 

 dosis, in the section not involved in the pathology, by a 

 similar increase of anterior heights compared with the pos- 

 terior ones (T3 21/19, T4 20/18, T5 22/20, T6 23/20, T7 

 22/21 mm). The remaining correction of the upright posture 

 must have been achieved by hyperlordosis of the cervical 

 spine and dorsal flexion of the head . Also with these compen- 

 satory adaptations, the position of the lower thoracic spine 

 was almost horizontal , causing deformation of the thorax and 

 heavy pressure on thoracic and abdominal internal organs. 

 The spinal deformation lowered substantially the living sta- 

 ture of the man. The difference between the value calculated 



Figure 6. Case no. 1. Radiogram of right sacroiliac an- 

 kylosis (afcovej, axial projection, and fused vertebrae T8-L1 

 (below), lateral projection. 



according to lengths of long bones and the measurement of 

 the body length in situ was 16.4 cm. In spite of these 

 changes, the hunchback was able to walk (possibly with the 

 help of a stick, whose head was put into his inner coffin) and 

 work. 



The described changes could, by the unnatural twist of the 

 spine, also have caused deep, oval depressions on terminal 

 plates of the neighboring vertebrae LI + 2 and L2 -I- 3, signs 

 of the prolapse of the nucleus pulposus of the intervertebral 

 discs (Figures 4,5). Osteochondrosis of the intervertebral 

 discs C5-6 and C6-7 and spondylarthrotic changes in the 

 joints T6-7 and T8-9 may also have been associated with the 

 adaptive changes of the gravity of the thoracic spine. 



SACROILIAC SYNOSTOSIS 



The right sacroiliac joint was ankylosed by means of a thick 

 layer (up to 4 mm) of newly formed bone covering the ante- 

 rior half of the upper margin and the upper half of the anterior 

 margin of the facies auriculares (Figures 6,7). The remaining 

 margins and the inner space were free. The left sacroiliac 

 joint presented osteophytic lipping on the margins of both 

 facies auriculares (2-5 mm). These changes could have been 

 adaptive, strengthening the basis of the deformed spine. 



Zagreb Paleopathology Symp. 1988 



