Spine Hyperkyphosis with Extensive Ankylosis in Seventeenth-Century Lucca (Italy) Disability in a Time of Crisis

Abstract

Archaeological excavations in the city of Lucca (Tuscany, central Italy) brought to light a cemetery of 91 burials for people of low social status dating to the first half of the seventeenth century that originated during a catastrophic epidemic event. There were two epidemics in this period, plague in 1630–1631 and petechial typhus in 1648–1650. A double tomb (T.29) contained the skeletal remains of a female aged 16–20 years and a non-adult aged five to six years. The female presented pathological skeletal alterations: the thoracolumbar tract of the spine from T5 to L1 was affected by a severe hyperkyphosis with a curvature of 180°, due to the complete collapse of the bodies of T8, T9, and T10, and ankylosis of bodies and posterior arches of all the vertebrae. On the endocranial surface of the cranium, two rounded depressions at the end of the enlarged meningeal sulcus of the left parietal are consistent with aneurysms of the meningeal artery. Moreover, the long bones of the limbs appeared slender, with all the indices of robustness lower than the sample average. The differential diagnosis suggested that hyperkyphosis could be attributed to a severe case of Pott’s disease, which likely caused prolonged paraplegia. Undoubtedly, the young woman received care and assistance during the acute phase of the disease, in the rehabilitation period, and for the rest of her life due to the pathological deformities of her spine.