Vertebral tuberculosis in ancient Egypt and Nubia • 187 



on terminal plates of the cervical vertebrae, between other 

 sacral bodies, along the cristal and ischiatic apophyses, on 

 humeral and femoral heads as well as on the distal ends of 

 radii, ulnae and fibulae. The pubic symphysis showed pha.se 

 3 of Todd ( 1920) having the range of 22-24 years. Parts of 

 the sternum were not fused. No age-dependent changes could 

 be found on the proximal ends of both humeri and femora, 

 except some rugged relief medially on the crista tuberculi 

 maoris, caused by muscular action. There was no arthritis, 

 no patellar and only beginning calcaneal osteophytes. On 

 vertebral bodies whose margins were not eroded by the 

 pathological process to be described (CI-T4, L2-5, SI ) no 

 lipping was present except slight beginnings on C4 and C5. 

 Also the intervertebral joints were intact except in the region 

 mostly involved in the pathology, where an arthrosis of T9- 

 10 and synostosis T 1 0-1 1 developed. 



The described features agree with a young adult age of 22- 

 24 years. 



SEX 



In spite of an only slightly developed glabella (Broca 2) and 

 supraorbital arches (Eickstedt 2) as well as a nasofrontal 

 transition in an only slightly concave arch and a very feeble 

 protuberantia occipitalis externa (Broca I), other features 

 pointed to the male side. There was a smoothly arched fore- 

 head, a thick and long mastoid process, a small and shallow 

 incisura mastoidea. situated within the mass of the process, a 

 moderately thick orbital margin, a slightly to moderately 

 developed processus marginalis, a slightly to moderately de- 

 veloped nuchal, but a medium to strongly marked mandibu- 

 lar muscular relief with a large eversion of the mandibular 

 angle. Also moderately large pelvic apophyses, a deep and 

 narrow ischiatic notch, absence of a preauricular sulcus, an 

 oval, moderately large pelvic inlet, an outstanding tuber- 

 culum pubicum, a flaring lower aspect of the pubic bone, a 

 rather acute subpubic angle (60°) and a low ischiopubic index 

 (left 64.0, right 63.6, according to Thieme and Schull 

 1957:269) argued unequivocally for the male sex. 



GENERAL PHYSICAL FEATURES 



The body build was moderately robust to robust with well- 

 developed muscular insertions. Stature, reconstructed ac- 

 cording to tables of Trotter and Gleser (1952) for American 

 Negroes, was medium (166.1 cm). 



SPINAL PATHOLOGY 



In contrast with case no. I , the whole thoracic and lumbar 

 spine showed a lytic process with inhibition of new bone 

 regeneration, progressing from above downward in the thor- 

 acic and from below upward in the lumbar section with max- 

 imum changes in TIO-LI, resulting in a double angular 

 kyphosis (Figures 8-13). Multiple small, larger, and big 



Zu^reb Faleopalholony Symp. I98S 



Figure 8. Case no. 2. Upper thoracic spine with lytic 

 changes on vertebral bodies, right lateral view. 



confluent cavities were characteristically localized on the 

 circumferential aspects of the vertebral bodies, portraying 

 the hematogenous spread of the infection via the paraver- 

 tebral plexus and anterior longitudinal ligament (Zimmer- 

 man and Kelley 1982:105). 



The cervical spine was devoid of pathological changes. 

 The upper third of the thoracic spine showed eroded pits on 

 the vertebral bodies, whose original shape had been mostly 

 preserved. In the middle part of the thoracic spine the de- 

 struction by confluent foci reached such an extent that only 

 stumps of vertebral bodies remained. They had bizarre forms 

 of columns bordering deep cavities and perforations. The 

 process did not penetrate into the neural arch and no changes 

 were present on intervertebral joints. 



The lower part of the thoracic spine was maximally af- 

 flicted by the pathology. The lytic process removed the whole 

 body of vertebra TIO and eroded the anterior parts of the 

 pediculi arcus vertebrae. The anteroposterior axis of the ver- 

 tebra had been rotated 70°, and consequently the spinous 

 process of T9 became the salient point of an angular kyphosis 

 (90°). Intervertebral joints T9- 10 were enlarged and eroded 



