Vertebral tuberculosis in ancient Egypt and Nubia * 189 





Figure 13. Case no. 2. Lumbar spine with 



wedge-shaped LI, lytic cavities in body 



L2, and more or less pitting in bodies L3- Figure 14. Case no. 2. Radiogram of spine showing lytic changes and double 



5, frontal view. angular kyphosis, which together equals 140°, lateral projection. 



(spondylarthritis), while joints TlO-ll were completely 

 fused (synostosis). These changes were secondary to un- 

 usually heavy strain. 



The wedge-shaped vertebra Tl 1 (anterior height 4 mm, 

 posterior height 20 mm) showed in its center a large abscess 

 cavity, bordered by lateral pillars of the remaining spongiosa, 

 thicker right (8-1 1 mm) than left (5-6 mm). Thebody of this 

 vertebra filled the empty space in the place of the destroyed 

 body TIO by rotation of the anteroposterior axis of the ver- 

 tebra including 90° with the axis of T9. Articular facets of the 

 intervertebral joint TII-12 were enlarged but not eroded. 



Vertebra T12 retained its original shape, but its whole 

 surface had been eroded by several large and partly merging 

 cavities. Small saucer-shaped erosions penetrated also into 

 both pediculi arcus vertebrae. Intervertebral joints TI2-LI 

 did not show any change. 



Another wedge-shaped vertebra L 1 (anterior height 3 mm, 

 posterior height 21 mm) revealed that the lytic prwess con- 

 tinued after the evacuation of the abscess and healing of the 

 pathologically fractured vertebral body. There were several 

 small or medium cavities and erosions on its surface (upper, 

 right lateral, and lower margin). Even both pediculi arcus 

 vertebrae were perforated from above (5x7 mm) downward 



Zagreb Paleopathology Symp. 1988 



(1x1 mm) and the anterolateral side of the right processus 

 articularis superior showed two tiny "borings." Owing to the 

 wedge shape of L 1 , its spinous process was the top of another 

 angular kyphosis of the spine (50°). 



Vertebra L2 retained its original shape, but several large 

 cavities penetrated its surface (anteriorly left of the midline, 

 on the left and right anterolateral aspect) together with small- 

 er pits and erosions. 



The following vertebrae L3-5 showed a decreasing quan- 

 tity of pitting, on a few places merging into larger defects. 

 Here we could observe well the progress of the described 

 process. All lumbar intervertebral joints were intact. 



The axis of the spine deviated in the sense of a dex- 

 troconvex scoliosis of the lower thoracic section. More im- 

 fwrtant, however, was the double kyphosis in the thor- 

 acolumbar transition reaching collectively an incredible 140° 

 angle. The deformation of the vertebral column can be seen 

 on the radiogram (Figure 14) together with the extent of 

 erosion and destruction of the individual vertebrae. Because 

 of absence of a compensatory growth of the vertebrae in the 

 sense of an adaptive lordosis, the thoracic spine starting at the 

 thoracolumbar bend in vivo was sinking from above back- 

 ward to downward and forward in a very oblique position. 



