Paleopathological examination of medieval spines with exceptional thoracic kyphosis most likely secondary to spinal tuberculosis. Historical vignette.

Spinal tuberculosis (TB) infrequently involves more than one to three vertebrae, and kyphotic angulation of greater than 30 degrees is rare in paleopathological specimens and clinical studies. The authors describe findings obtained in two spines (dating from the Early and Late Middle Ages). Spinal TB was present in both as well as sharply angulated kyphosis (approximately 180 degrees) resulting from complete destruction of five and seven vertebral bodies, respectively. In these two specimens obtained in individuals older than 12 years of age at the time of death we observed no involvement of the disease in posterior vertebral elements, and the laminae showed osseous fusion without signs of infection. The osseous diameter of the spinal canal was not narrowed in either case. These findings are discussed in the context of modern medical knowledge and paleopathological and genetic examinations.