新疆加依墓地人体脊椎溶解的古病理学

Paleopathology of vertebras osteolysis of the person from the Jiayi Cemetery,Xinjiang

本文对出土于新疆吐鲁番加依墓地青铜至铁器时代的2例罕见脊椎病理性损伤个体,进行了古病理学分析与诊断。经鉴定,个体M172是一名10-12岁的未成年人,个体M167是一名35岁左右的女性,两例个体的脊椎均出现较为严重的骨性溶解病变:终板损坏,内部松质骨溶蚀、吸收,椎体中部空化形成中空现象。其中个体M172除第7胸椎和第3腰椎发生溶解病变之外,手指、耻骨、肩胛骨等多部位均发现局灶性溶骨损伤,肋骨和胫骨局部反应性新骨显著;个体M167的第3、4腰椎由于溶解严重发生椎体塌陷特征。通过CT和X光影像学分析骨骼损伤形态、骨骼损伤区域特征,并结合临床医学资料进行鉴别诊断,认为两例个体患有化脓性骨髓炎、布鲁氏菌病、放射线菌病、骨癌转移以及一些其他真菌感染的可能性较小,推测这两例个体疑似罹患脊柱结核病。

This paper made a paleopathological analysis and diagnosis of two cases of rare vertebras pathological lesions from the Jiayi Cemetery,a Bronze-Iron Age cemetery from Xinjiang,China.We speculated on the most likely type of disease,and at the same time,combined with the living environment of these two individuals,we explored the external factors that caused the patients to become ill.After identification,M172 is a minor of 10-12 years old,and M167 is a female about 35 years old.Two cases showed serious osteolytic lesions in the vertebras:endplate damage,internal cancellus dissolution and absorption.Before the paleopathological diagnosis of bones,we first observed the local bone damage through a super-depth three-dimensional digital microscopic analysis system.We found that there were traces of healing in the bones in the damaged area,thus ruling out the possibility of bone damage caused by buried factors,All skeletal injuries are caused by diseases that the individual suffered from during his or her lifetime.The cavitation of the middle vertebral body had formed hollow phenomenon.In M172,focal lytic lesions were found in hand phalanges,vertebra,pubis and scapulae,ribs and tibia showed significant local new bone formation;the third and fourth lumbar vertebrae of individual M167 showed vertebral collapse due to severe dissolution.Through CT and X-ray imaging analysis of bone injury morphology,bone damage area characteristics,combined with clinical medical data for differential diagnosis,the results suggest that Degenerative arthritis,compression fractures,and Scheuermann disease were excluded because they do not cause osteolytic changes,and two individuals might suffer from spinal tuberculosis,rather than purulent osteomyelitis,brucellosis,actinomycosis,bone cancer metastasis and some other fungal infection.Archaeological excavations of the site show that from the 8th century BC to the 5th century BC,people living in the Turpan area lived a life based on animal husbandry,mainly raising cattle,sheep and horses,which led to their frequent contact with livestock.Cattle are considered to be among the most infectious livestock to humans,including the consumption of meat and dairy products and even the reuse of feces and urine.In addition,backward medical and health factors increase the probability of zoonosis and meet the conditions for the spread of tuberculosis.The Turpan Basin is located in the middle of the Eurasian steppe and was an important location on the ancient Silk Road in China.There were close exchanges between different groups of people.This study is of great significance to the health assessment of the population in the region.