Diseases of the spine in South American mummies.

OBJECTIVE: The skulls and spinal columns of people from ancient civilizations, which frequently are found in a preserved state at archeological sites, can provide a large amount of information about these individuals' physical condition through paleopathological investigation. METHODS: This study represents the examination of more than 700 human remains dating back more than 8000 years that were recovered from archaeological excavations in the Andean region of southern Peru and northern Chile. RESULTS: Examples of congenital malformations, degenerative processes, infectious diseases, neoplasias, and traumatic diseases were discovered. Congenital anomalies such as spina bifida occulta were relatively common in these populations. No cases of meningomyelocele were discovered. The most common pathological findings were degenerative changes of the vertebral bodies. Large cervical and lumbar osteophytes were identified in some remains. Several cases of cervical spondylosis were determined to be the result of an occupational disease resulting from carrying heavy loads on the back. These heavy loads were supported by wearing around the forehead a tumpline, known as a capacho. The most common infectious disease process in the spine was due to tuberculosis. The diagnosis was made by radiological and histopathological studies, and in several cases the organism Mycobacterium tuberculosis was identified in the soft tissues. Metastatic lesions on the vertebral bodies were identified in a single case. Examples of traumatic spinal injury were rare. Compression fractures were noted infrequently. CONCLUSION: Diseases of the spinal column in the ancient inhabitants of the Andean region of South America were similar to those that affect the present-day population of that area.

Severe neural tube defect syndrome from the Early Archaic of Florida.

The Early Archaic Windover site is on the east coast of mid-peninsular Florida. A subadult skeleton (about 15 years old at time of death) was recovered with multiple pathologies related to spina bifida aperta of the neural arch at the L3-S2 level of the spine. Other evidence indicates s.b. cystica, although the degree of severity of the dysraphic neural tube syndrome cannot be directly determined. In addition to spina bifida, the lumbar region is scoliotic from malformation of zygapophyses. The defect is accompanied by severe infection of the right tibia and fibula, and disuse atrophy of long bones. It is hypothesized the NTD (neural tube defect) led to progressive sensory deprivation, which in turn led to increased loss of mobility, ulceration, and risk of serious infections. Other "minor" anomalies such as cone-shaped epiphyses, enlarged nutrient foramina, and vental vertebral cavitation are also discussed. The chronic nature of these defects provide insight on the high level of long-term care and attention provided a severely handicapped individual 7,500 years ago.

Controversias en el tratamiento del mielomeningocele: importancia del enfoque multidisciplinario / Controversies in the treatment of myelomeningocele: importance of the multidisciplinary approach

La reparación precoz del mielomeningocele probó mejorar substancialmente la morbimortalidad de una serie de 78 recién nacidos consecutivos portadores de esta afección, tratados por el autor. Se discuten los criterios de selección y se enfatiza la importancia del tratamiento total no selectivo y del equipo multidisciplinario