REGARDING OCCULT SPINAL DYSRAPHISM (SPINA BIFIDA OCCULTA), FOCUSING ESPECIALLY ON A MEDIEVAL POPULATION FROM IAȘI (original) (raw)
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Occult spinal dysraphism is a congenital anomaly with a relatively high incidence, which may be located along the spine, from the atlas to the sacrum; it is frequently met in the lumbo-sacral junction, and sometimes it affects the entire dorsal sacral region. Spina bifida occulta usually occurs in relatively high percentages in a population (2-30% of the cases). Despite extensive research, the causes of the appearance of spina bifida have not been completely understood; it is, probably, a multifactorial anomaly, most cases of spina bifida are considered to have been caused by complex polygenic interactions with environmental factors. The osteological material dug up in 2007 at the Centre of History and European Civilization from Iași, in the cemetery of the "St. Neculai-Ciurchi" Church (XVI-XVIII centuries), has a total of 680 skeletons taken from 230 graves. In the medieval population from Iași, occult sacral spinal dysraphism occurs only in 2 cases (mature males), having a percentage of 1.55% of the total number of sacrums and 3.22% of the number of masculine sacrums. Cervical, thoracic and lumbar interlaminar dehiscence did not occur in reports in the subgroup of male nor female. We have found no case of cervical, thoracic or lumbar interlaminar dehiscence.
Spina bifida occulta is the most common congenital malformation localized at the level of the spinal column from the atlas to the sacrum. The most frequent cases of spina bifida appear in the lumbar-sacral region, especially at the level of the sacrum bone. The maternal nutritional status, the exposure to teratogenic factors and the genetic predisposition may act together leading to the appearance of spinal dysraphisms. The osteological material exhumed in 2008 by the Center of European History and Civilization of Iași, from the necropolis localized in the Eastern part of the ex-Princely Court ("Curtea domnească") of 17 th century), sums up to 111 skeletons from 60 inhumation graves. The occult spinal sacral dysraphism in case of the medieval population of Iași appears in 6 cases (5 men with ages between 18 and 60 and one woman with the age between 18-20 years). The percentage of the occult spinal dysraphism is of 6.59% in case of the total number of individuals where we deal with the presence of the sacrum bone, of 7.57% for the male group and of 4% if we refer to the female group.
Spina Bifida Occulta in Medieval and Postmedieval Times in Eastern Romania
2016
This paper provides bioarchaeological evidence of Spina Bifida Occulta (SBO) in human skeletons discovered in medieval and post-medieval sites of Eastern Romania and evaluates its prevalence and patterns by examining its relationship to age, sex, type of sites (urban, elite and rural), and its morphological patterns. The skeletons found in burial and reburial tombs from five necropolises of the 14–19 centuries, discovered in Eastern Romania, were analysed to determine individuals’ age and sex, pathologies and anomalies. Sacral SBO was identified in 11 subjects, for an overall prevalence of 4%; sacral SBO seems to be more common in endogam groups, as it is assumed to be that of the Princely Court. Apparently, this defect is more frequent in men (9 cases were males), its prevalence decreasing with age (from an overall value of 5.47% in young adults to 2.85% in old ones), but no statistically valid association could be demonstrated between the presence/absence of SBO and sex or age. Mo...
Lumbo-sacral malformations and spina bifida occulta in medieval skeletons from Brittany
European Journal of Orthopaedic Surgery & Traumatology, 2012
Introduction Compared with the other French regions, the incidence of neural tube defects is raised in Brittany. It can be explained by the Celtic origin of the Britton people, who migrated from Great Britain in the High Middle Ages. Notwithstanding, there are no historical or archeological evidences of the occurrence of these pathological conditions in medieval Brittany. Materials and methods We investigated the incidence of lumbo-sacral malformations on the skeletal remains of 30 individuals excavated from the necropolis of Saint-Urnel (southwest Brittany). Results We found out several anatomical variations among five specimens, three of which had spinal dysraphism involving the sacrum. Conclusion Our results enrich the very few paleopathological data about spinal dysraphism, from the Hippocratic Corpus to the first description of Spina Bifida in sixteenth century. But, their interpretation remains delicate until the same genetic factors are shown in the etiology of both open and closed spinal dysraphism.
Spina bifida: A diagnostic dilemma in paleopathology
Clinical Anatomy, 2010
This article provides information regarding the etiology, pathogenesis, and skeletal manifestation of spina bifida or spinal dysraphisms. On the basis of a review of the medical literature, it addresses discrepancies in documentation and interpretation of spina bifida in paleopathology. Furthermore, it offers suggestions for use of universal terminology and highlights the difficulties in the specific diagnosis of dysraphisms in skeletal remains. In addition, the necessity of examining the entire skeleton for abnormalities to distinguish simple delay/failure of fusion of the posterior neural arches from other occult spinal dysraphisms is emphasized, as it is the need for stratification of the sample by age and sex when reporting frequencies of sacral spina bifida occulta.
A Study of Total Spina Bifida of the Sacrum in Western India
2013
Background: Spina bifida is the generic term for a range of discrete defects of neurulation and subsequent vertebral formation. Numerous anatomical variations of the sacrum have been reported. However, total spina bifida of the sacrum has never been reported in Gujarati population of Western India. These variations may be found in the patients of low back pain and neurological symptoms during radiological investigations or during caudal epidural anaesthesia in labour and lower abdominal surgeries or on post mortem examination or even during dissection of human body and osteology class for medical students. Objective: The study was designed to know the prevalence of total spina bifida of the sacrum in Gujarati population of Western India .Considering the variation; we conduct this study as a prelude to any type of work for diagnostic and therapeutic purposes in low back pain, spinal surgery and for interventional procedures like epidural anaesthesia. Materials and Methods: 302 intact dry human sacra of unknown sex were studied from the Department of Anatomy, B.J. Medical College Ahmedabad; Government Dental college, Ahmedabad; Medical college, Vadodara and Government Medical College, Surat in Gujarat. The specimens were carefully examined and total spina bifida of the sacrum if found was recorded. Results: We found 5(1.65%) out of 302 specimens of sacrum with total spina bifida of the sacrum. Conclusion: The present study shows that the incidence of sacrum with total spina bifida of the sacrum in Gujarati population of Western India is 1.65%. This developmental defect must be considered for the sake of patient safety before undertaking caudal epidural block.If not serious complications such as dural puncture may easily occur. It is also important for the accurate diagnosis of patients with low back pain. It may be associated with spina bifida occulta or spina bifida cystica. The knowledge of this anatomical variation is of paramount importance to spinal surgeons, anaesthetists, radiologists, forensic experts, morphologists and clinical anatomists.
Pathological Anatomy of Spina Bifida
The Spina Bifida, 2008
Spina bifida occulta results from incomplete closure of the neural tube around the twentieth day of embryonic development . Spina bifida was described in the medieval literature and was recognized even earlier. Indeed, the association of foot deformities with sacral hypertrichosis may be the origin of the mythological figure of the satyr [2]. The term spina bifida encompasses the entire central nervous system, ranging from merely an absent spinous process through to myelomeningocele (MMC), Chiari malformation and hydrocephalus to cortical cytoarchitectural changes .
Cervical Spine Anomalies: Children in One of the Oldest Churches in Poland
International Journal of Osteoarchaeology, 2017
This paper presents pathological changes indicative of type II Klippel-Feil syndrome identified in the skeleton of a child uncovered in one of the oldest Christian churches in Poland (first half of the 11th century) with the archaeological layer containing the burial dated to the 13th-15th centuries. The age at death of the child was estimated at 9 to 10 years. The third and fourth cervical vertebrae of this individual were fused asymmetrically, leading to torticollis. The apex of the dens axis (odontoid process) was V-shaped, which is consistent with clinical descriptions of ossiculum terminale. The laminae of the second sacral vertebra were found to be fused, but positioned asymmetrically with respect to one another, while the laminae of the third and fourth vertebrae were hypoplastic, suggesting spina bifida of the sacrum. This configuration of anomalies is symptomatic of type II Klippel-Feil syndrome. In addition, the studied individual revealed heterotopic ossification on the supinator crest of the ulna, which may have arisen as a result of dislocation of the elbow joint.
International Journal of Paleopathology, 2019
Objective: To document sacral spina bifida occulta (SSB0) prevalence in a population sample from the Dakhleh Oasis, Egypt, and address methodological issues in recording and quantifying SSBO variations. Materials: 442 adult sacra from two temporally disjunct samples from the same deme traversing the 3rd intermediate (TIP) and the Roman Periods. Methods: Sacra were scored for SSBO, excluding the sacral hiatus. Risk of SSBO was calculated with the common odds ratio and statistical significance by X 2. Data were compared to other archaeological SSBO data. Results: SSBO was present in 15.6% of the sample with a slight, but not significant, temporal increase (TIP to Roman Period) in males, and a significant age-correlated increase in both sexes. Most open sacra occurred in young adults. Conclusions: Data support that SSBO can be considered as a morphogenetic variant. Dakhleh data fall within the prevalence range for most populations, however inter-population comparisons are complicated by methodolo-gical inconsistencies. Significance: SSBO can be used in paleogenetic research. Limitations: Methodological differences in scoring SSBO prevent effective comparative study. Suggested future research: Future studies require more rigorous and standardized scoring methods. aDNA may be used to corroborate the morphogenetic value of SSBO and determine its clinical significance.