Severe chest polytrauma and vertebral number variation of an old woman from the Early Middle Ages.

This study describes a case of polytrauma of the axial skeleton accompanied by a spinal anatomical variation of an early medieval old female skeleton (dated to the 8 ^th -9 ^th century AD), with the purpose of clarifying the origin of the condition and to understand its impact on the life quality of the individual. The skeleton was subjected to macroscopic and X-ray examination. An anthropological analysis discovered the skeleton is well preserved, gracile, and with significant traces of physical activity. A detailed survey of the spine revealed there are six cervical, 12 thoracic, and six lumbar vertebrae. The examination of the pathological changes discovered a severe chest polytrauma (a compressive fracture of the 9th thoracic vertebra and multiple rib fractures), associated with pleural rind ossification, severe osteoarthritis, and ankylosis of both intervertebral and costovertebral joints. The irregularity in the number of vertebrae was determined as a double meristic vertebral variation probably caused by a presomitic mesoderm segmentation disorder. The pathological changes examined were assumed to be of traumatic aetiology with a possible osteoporotic background, and were compared with similar changes caused by tuberculosis and ankylosing spondylitis. The woman had to have been suffering from severe back pain, her back was deformed to a dowager's hump, but she managed to survive for many years after the traumatic event.