Tuberculosis bacteria have been consuming spines for centuries.

Image of Nespaheran, an Egyptian mummy from the time of the 21st Dynasty with spinal tuberculosis.  Credit: Wellcome Library, London

Image of Nespaheran, an Egyptian mummy from the time of the 21st Dynasty with spinal tuberculosis. Credit: Wellcome Library, London

In 1891 during an excavation in Thebes, French Egyptologist Eugène Grébaut discovered a mummy from the 21st dynasty (between 1077 BC and 943 BC).  The mummified body belonged to Nespaheran, a priest of Amun, who was between 25 and 30 years old when he died.  Osteological analysis revealed something interesting, a severely curved back due to destruction of the lower thoracic and upper lumbar vertebrae, which researchers believe was caused by spinal tuberculosis.

Tuberculosis (TB), also known as consumption, is a disease historically associated with poverty, overcrowding, and malnutrition.  It was a major cause of death of humans from the 17th to 19th centuries.  In the last half of the 19th century, the occurrence of tuberculosis cases experienced a sharp decline.  In the last couple of decades, however, there has been an increase in TB infections, in part due to HIV.

TB is caused by a bacterium from the genus Mycobaterium, two of which infect humans M. tuberculosis and M. bovis (M. bovis will not be discussed in this article but more information is available here).   M. tuberculosis infects the lungs, and is spread via contaminated bodily fluids (i.e. saliva or mucus) that are dispersed during a cough or a sneeze.  Once in the lungs the infection can spread through the blood stream to other parts of the body, including bones.   Once the TB bacteria is in the spine the infection is then called spinal tuberculosis.

Spinal tuberculosis, also known as Pott’s disease, makes up half of the cases of skeletal TB.  When in the spine, the infection is largely limited to the intervertebral disk space and vertebral bodies, and most often affects the lower thoracic vertebrae or the upper lumbar vertebrae.  When the infection sets into the vertebral bodies an abscess can form causing the vertebrae to collapse and a severe curvature to form.

As the disease progresses, the TB bacteria will eat away at the vertebral bodies eventually causing the bones to collapse and fuse together (ankylosis).  When the vertebral bodies cave in it produces a curvature of the spine (kyphosis), also known as roundback.

Below are images of collapsed spines infected with spinal TB.

Initial destruction of bone in the vertebral bodies due to spinal TB.  Credit: Smithsonian Institution.

Initial destruction of bone in the vertebral bodies due to spinal TB. Credit: Smithsonian Institution.  Click here to see full size image.

Spine showing evidence of TB.  Image Credit University of Manchester.

Spine showing collapsed spine due to TB. Image Credit University of Manchester.

Partial spinal column of a caucasian male, 12 to 14 years old, with probable tuberculosis.  Image courtesy of: Darnall's Chance House Museum via the Smithsonian Institution.

Partial spinal column of a caucasian male, 12 to 14 years old, with probable tuberculosis. Image courtesy of: Darnall’s Chance House Museum via the Smithsonian Institution.

Sources:

Garg, R.K. and Somvanshi D.S. (2011 September). Spinal tuberculosis: A review.  The Journal of Spinal Cord Medicine.  Volume 34 (5): 440-454.  Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/22118251

Waldron, T. (2008).  Paleopathology (Cambridge Manuals in Archaeology).  New York, NY: Cambridge University Press.



Categories: History

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