High assimilation of the sacrum in a sample of American skeletons: Prevalence,pelvic size,and obstetrical and evolutionary implications

High assimilation sacrum is fusion of the caudal‐most lumbar vertebra to the first sacral vertebra. Previous studies have shown that high assimilation is associated with clinical problems, including obstetrical difficulty. This study used adult American males (n = 1,048) and females (n = 1,038) of the Hamann–Todd and Terry skeletal collections to determine the prevalence of high assimilation and its effect on pelvic size, and to consider the obstetrical and evolutionary implications of high assimilation. The prevalence of high assimilation in this sample is 6.3%, with males and females not differing significantly from one another in their prevalence. This prevalence is near the median for that reported in 41 other samples. In both males and females, individuals with high assimilation have significantly longer anteroposterior and posterior sagittal diameters of the inlet, and shorter sacrum compared to those with a nonassimilated sacrum. Females with high assimilation have a significantly narrower sacral angulation (i.e., reduced inclination of ventral axis of sacrum), and shorter posterior sagittal diameter of the outlet compared to those with a nonassimilated sacrum. A short posterior sagittal diameter of the outlet is associated with childbirth difficulty. As high assimilation is partial homeotic transformation of a lumbar vertebra, this study supports previous research that homeotic transformation of vertebrae is selectively disadvantageous. Am J Phys Anthropol, 2009. © 2008 Wiley‐Liss, Inc.     

Chronology of fusion of the primary and secondary ossification centers in the human sacrum and age estimation in child and adolescent skeletons

Little is known about fusion times of the primary and secondary centers of ossification in the sacrum, particularly from dry bone observations. In this study, the timing of union of these centers was studied in a sample of modern Portuguese skeletons (90 females and 101 males) between the ages of 0 and 30 years, taken from the Lisbon documented skeletal collection. A three‐stage scheme was used to assess fusion status between ossification centers as unfused, partially fused and completely fused. Posterior probability tables of age, given a certain stage of fusion, were calculated for most anatomical locations studied using both reference and uniform priors. Partial union of primary centers of ossification was observed from 1 to 8 years of age and partial union of secondary centers of ossification was observed from 15 to 21 years of age. The first primary centers of ossification to complete fusion are the neural arch with the centrum of the fifth sacral vertebrae and the last are the costal element with the centrum of the first sacral vertebra. The annular and sacroiliac epiphyses are the first, among the secondary centers of ossification observed, to complete fusion, after which the lateral margin fuses. This study offers information on timing of fusion of diverse locations in the developing sacrum useful for age estimation of complete or fragmented immature human skeletal remains and fills an important gap in the literature, by adding to previously published times of fusion of primary and secondary ossification centers in this sample. Am J Phys Anthropol 153:214–225, 2014. © 2013 Wiley Periodicals, Inc.     

Using magnetic resonance imaging to identify the lumbosacral segment in children

Identification of the lumbosacral (L-S) segment on magnetic resonance (MR) images is important for appropriate treatment of disease in the lumbosacral (L-S) area. In the study, data obtained from plain A-P radiographs of the L-S spine and sagittal MR imaging scans (sagittal T1- and T2-weighted sequences) of the L-S spine and sacrum with the coccygeal bone, are analyzed. Twenty-six children aged 10 to 14 years were examined for back pain. On the standard A-P radiographs of the L-S spine, a L-S transitional vertebra as classified according to the method of Castellvi et al. was found in 17 subjects. The problem arose as to whether this was lumbalisation or sacralisation, and how to determine which vertebra was L5 wich S1. On the sagittal MR imaging studies the same question applied. A need emerged for a simple method which would identify the L-S segment on the sagittal MR imaging studies of the L-S spine in children so that in case of a tumor, inflammation, spondilolystesis, or protrusion of a disc, the level in the L-S spine where the problem is localized can be accurately identified. To this objective we selected the method using detection of the S1 vertebra. This involved that, in addition to the sagittal MR imaging scans of the L-S spine, sagittal images of the sacrum and coccygeal bone be also obtained. on the T2-weighted sequence, the sacrum can be clearly distinquished from the coccygeal bone. By counting from the S5 up, the S1 vertebra can be accurately identified. Determination of the S1 vertebra enables detection of the L5 vertebra and, in turn, of all other lumbar vertebrae. In patients in whom a T2-weighted MR studies were done S1 could be precisely determined and so could the L5 vertebra. In this process, whether the patient had a transitional vertebra or whether there was lumbarisation or sacralisation was irrelevant.     

“Lucy” (A.L. 288‐1) had five sacral vertebrae

A “long‐backed” scenario of hominin vertebral evolution posits that early hominins possessed six lumbar vertebrae coupled with a high frequency of four sacral vertebrae (7:12‐13:6:4), a configuration acquired from a hominin‐panin last common ancestor (PLCA) having a vertebral formula of 7:13:6‐7:4. One founding line of evidence for this hypothesis is the recent assertion that the “Lucy” sacrum (A.L. 288‐1an, Australopithecus afarensis) consists of four sacral vertebrae and a partially‐fused first coccygeal vertebra (Co1), rather than five sacral vertebrae as in modern humans. This study reassesses the number of sacral vertebrae in Lucy by reexamining the distal end of A.L.288‐1an in the context of a comparative sample of modern human sacra and Co1 vertebrae, and the sacrum of A. sediba (MH2). Results demonstrate that, similar to S5 in modern humans and A. sediba, the last vertebra in A.L. 288‐1an exhibits inferiorly‐projecting (right side) cornua and a kidney‐shaped inferior body articular surface. This morphology is inconsistent with that of fused or isolated Co1 vertebrae in humans, which either lack cornua or possess only superiorly‐projecting cornua, and have more circularly‐shaped inferior body articular surfaces. The level at which the hiatus' apex is located is also more compatible with typical five‐element modern human sacra and A. sediba than if only four sacral vertebrae are present. Our observations suggest that A.L. 288‐1 possessed five sacral vertebrae as in modern humans; thus, sacral number in “Lucy” does not indicate a directional change in vertebral count that can provide information on the PLCA ancestral condition. Am J Phys Anthropol 156:295–303, 2015. © 2014 Wiley Periodicals, Inc.     

Spondylolysis: its nature and anthropological significance

Spondylolysis of the lower back is a kind of vertebral fracture that is unique to humans being related to anatomical features such as the lumbar curve which facilitate upright posture and bipedal locomotion in this species. It is virtually never seen in children before the age of walking and has not been observed in adults who were never able to walk. Although apparently produced on occasion by acute trauma, spondylolysis usually develops as a fatigue fracture in response to sustained or repeated stress. The occurrence of spondylolysis varies greatly from population to population with the highest frequencies, approaching 50%, seen in northern Alaskan and Greenlandic Eskimos. Males are affected more frequently than females, and the condition is common in athletes, particularly gymnasts, divers, polevaulters, and American football players. It is also seen among heavy laborers, especially if the job requires lifting. Although generally approached as a pathological condition requiring corrective treatment, spondylolysis, as well as the anterior slippage (olisthesis) that frequently accompanies it, usually produces relatively mild symptoms if any at all. In fact, it many even provide advantages such as greater flexibility in the lower back.     

Costal process of the first sacral vertebra: sexual dimorphism and obstetrical adaptation

The human sacrum is sexually dimorphic, with males being larger than females in most dimensions. Previous studies, though, suggest that females may have a longer costal process of the first sacral vertebra (S1) than males. However, these studies neither quantified nor tested statistically the costal process of S1. This study compares S1 with the five lumbar vertebrae (L1 to L5) for a number of metric dimensions, including costal process length. Four issues are addressed, the: 1) hypothesis that females have a longer costal process of S1 than males; 2)hypothesis that homologous structures (i.e., costal processes of L1 to S1) differ in their direction of sexual dimorphism; 3) importance of the costal process of S1 to the obstetrical capacity of the pelvis; and 4) evolution of sexual dimorphism in costal process length of S1. One hundred ninety-seven individuals, including males and females of American blacks and whites, from the Hamann-Todd and Terry Collections were studied. Results show that males are significantly larger than females for most vertebral measurements, except that females have a significantly longer costal process of S1 than males. Costal process length of S1 is positively correlated with the transverse diameter and circumference of the pelvic inlet. The magnitude of sexual dimorphism in costal process length of S1 ranks this measure among the most highly dimorphic of the pelvis. Compared with the humans in this study, australopithecines have a relatively long costal process of S1, but their broad sacrum was not associated with obstetrical imperatives.     

Asymmetrical spondylolysis

The objective of this study was to examine examples of spondylolysis in which the pattern of separation was clearly asymmetrical, in order to learn more about the process of bone separation that produces this condition. Although the primary focus was on unilateral complete separation, examples of asymmetry represented by incomplete separation and by complete bilateral separation where the separation sites are in different locations on the two sides were included. Two collections were used, one consisting of Canadian Inuit skeletons curated at the Canadian Museum of Civilization, and the other of 48 individual examples of asymmetrical spondylolysis from sites in a variety of localities curated by several different institutions. The first collection was studied primarily to observe early manifestations of spondylolysis, particularly incomplete separation, while various patterns of asymmetrical complete separation were the focus of the second. The results indicate that asymmetry is part of the earliest osteological picture of spondylolysis, with right-sidedness predominating, a condition perhaps related in some way to handedness. The right-side predominance appears to decrease with age. The ratio of unilateral to bilateral separation ranges from 3-33% in different studies, and a significant number of the unilateral separations have spina bifida occurring in the same vertebra. Overall, the specimens examined here, considered along with clinical cases, nicely illustrate a progression of spondylolysis. A unilateral separation may heal, it may progress to bilateral separation, or it may remain as a permanent condition, producing a pattern of degenerative changes that can include spondylolisthesis. A unilateral healing of bilateral complete separation is likely a rare phenomenon, at least after the separations have reached a certain level of maturity.     

Evolution of the sacrum in hominoids

In order to study the formation of the sacrum during the primate evolution, a new way of numbering mammalian vertebrae is presented; this demonstrates that the thoracolumbosacral complex is fixed at 22 vertebrae in 80% and at 22 +/- 1 in 100% of the cases. The shift of a vertebra from one type to another occurs either at the thoracolumbar or at the lumbosacral junction and not at the cervicothoracic junction. Rarely does the shift take place at the sacrococcygeal junction. Data from 318 primates reveal that the seven original lumbar vertebrae of the Old World monkeys are reduced in the great apes by a caudad "thoracization" of one to two lumbar vertebrae and a cephalad sacralization of one to four lumbar vertebrae. In the apes, sacralization is not total and different stages that are intermediate between lumbar and sacral are described. In Homo sapiens there is a total sacralization of the last two original lumbar vertebrae. In addition, development of the sacral wings (alae) is minimal in apes and reaches its maximum in hominids. The tendency of the hominoid sacrum to incorporate the last lumbar vertebrae and to widen markedly provides for an enhanced articulation of the sacrum with the ilium and offers a firm base of support for the trunk during erect posture. This is necessary for the support of the weight of the trunk above the sacrum and for the stabilization of the body during bipedal posture and locomotion. Encephalization did not play any major role in the widening of the sacrum since the former by far preceded the latter.     

On the Sacral Plexus and Sacral Vertebra of Lizards.

The authors mention that of late it has been recognized that, in any attempt to answer the question as to which vertebra of any lower animal answers to the first sacral vertebra of Man, the nervous no less than the osteological relations of the parts should be carefully investigated. And it has been considered that the nervous rather than the osteological relations should be deemed the more important: in fact it has been sometimes asserted that the nerves must be taken as the fixed points, and that the bones must rather have their homology decided by the nerves, than vice versa. Should it be possible to show that in any group of reptiles, both the nervous and osteological relatious of any vertebra constautly agree with the nervous and osteological relation of Man's first sacral vertebra, the homology between such two parts may well be taken as thereby established; but if either of these sets of relations exhibit discrepancy, then of course such homology cannot be considered satisfactorily determined. Nor can we justly set aside osteological in favour of nervous resemblances if it should turn out that the nerves themselves exhibit notable variations of conditions as we pass from one allied form to another–a fortiori if there should be variations in this respect even within the limits of a species. It might surely be anticipated that more or less variation would be found to exist inner‐vous as well as in skeletal structures; and in the event of such anticipations being justified, the determination of sacral homology must depend upon a comparison of the values of the conflicting claims of different degrees of resemblance in both the osseous and nervous systems–unless we prefer to consider the osteological sacrum and the nervous sacrum as two distinct structures, which may or may not completely coincide, and may or may not widely diverge. The authors afterwards discuss the opinions held by Professor Gegenbaur with regard to the pelvic relations in birds and some reptiles, also those of Professor Hoffmann concerning the lumbar and sacral plexuses of Batrachians and Reptiles. Then follows an account of dissections of the Chameleon (Cha‐mceleo vulgaris), the Green Lizard (Laeerta viridis), the common Teguexin (Teius teguexin), the Bearded Lizard (Grammatophora barbata), the Agama colonorum, the Tuberculated Lizard (Iguana tuberculata), and of the Monitor (M. arenaria). On these dissections are based some remarks on the general condition of the nervous and osseous structures of the sacral region in Lizards, according to their views and as compared with those held by G‐egenbaur and Hoffmann. To this succeed other chapters devoted to a consideration of the sacral region of Batraehians, to the sacral region of Mammals, and to the sacral region of Birds, each discussed in a similar spirit. Their generalizations to the foregoing may be thus summarized:– It appears, then, that in Lizards generally, the lumbar plexus may be formed by from two to three roots, aud that the most pre‐axial of these is here in advance of the fourth presacral nerve, while the most postaxial root is never more postaxial than the first presacral nerve. But Monitor and Ohamwleo present a slight exception in certain respects. In all the Eeptilia examined and enumerated by the authors, the transverse processes which abut against the ilium are wholly or in part parapophysial, and are in serial relation (serial liomo‐logues) with the capitular processes (or the capitular parts of the transverse processes) of the more preaxial vertebrae. The junction of the sacral vertebrae with the ilium is much postacetabular in Saurians; but in Crocodilia and Tortoises (some at least) it is about opposite the acetabulum. In Batrachians the transverse processes abutting against the ilium are parapophysial, but diapophysial in nature like those of Eeptiles. In Mammals as compared with Lizards, it would seem, with respect to nerves, that the first and second sacral vertebra? (say, for instance, of the Cat), answer very well to the two vertebrae with enlarged transverse processes of Lizards, while osteologically they of course also answer very well to them. There can be little doubt, however, that the first two sacral vertebrae of the Cat are to be considered homologous with the anterior human sacral vertebra¹; and therefore it would seem that the two ilium‐joining vertebrse of Lizards should be considered homologous with the anterior human sacral vertebrae. In Man, the Cat, and also in other Mammals down to the Echidna, the transverse processes abutting against the ilium are parapophysial, like those of Eeptiles and Batrachians. In all the Mammals examined by the authors, however, the junction of the sacral transverse processes with the ilia is preacetabular, although that junction is much less preacetabular in position in Man than it is in most Mammals. Altogether, from the osseous and nervous conditions evinced together in the groups hitherto referred to, the authors propose the following definition of a “Sacral Vertebra” in Mammals, Eeptiles, and Batrachians:–“ vertebra'ivithparapophysial transverse processes winch abut against the ilium, preaxial or post‐axial or opposite to the acetabulum, and having a root of the sciatic plexus coming forth either immediately preaxiad or postaxiad of it.” This definition will exclude from the sacrum, as not abutting against the ilium, of Man, the more posterior vertebrse called “ sacral” in anthropotomy. But in the lower mammals (even already in Apes) the number of so‐called “ sacral ” vertebrre augments more or less with age by the ankylosis of the sacral vertebras, so as not to render the extent of the “ sacrum ” very variable. It would surely be well, then, to distinguish the human sacral vertebra, like the ribs, into true and false, those being the true sacral vertebrae which abut against the ilium. In Birds the determination of the homological relations of the different parts of the postdorsal part of the spinal column is a matter of much difficulty. On the whole, and seeing on the one hand the manifest homology between the sacral vertebrae of Man and Lizards by the help of Crocodiles and Tortoises, and on the other hand the manifest homology between the sacral vertebrae of Lizards and the posterior parapophysial vertebras of most Birds, the authors think it better to regard the latter vertebras in Birds as alone truly sacral, and to regard such forms as Bwceros, Pica, and certain Parrots as differing from the rule of the Class in the suppression of their parapophysial processes, sm&Fregatta as differing from the same rule by the development of parapophyses in all the vertebras of this region. The sacral vertebra? in Birds may be defined, then, as “vertebrce having one of the more postaxial roots of the sciatic plexus coming forth either immediately preaxiad or postaxiad, and having parapophysial transverse processes abutting against the ilium, such vertebra being placed immediately postaxiad to vertebra which are devoid of such parapophyses, or else being the homologues of a vertebra so conditioned in most birds. By the combination of these two definitions, as given above (the one for Mammals, Eeptiles, and Batrachians, and the other for Birds), it seems to the authors that the sacral vertebras may be defined in all Vertebrata above Pishes which have pelvic limbs.     

Sacral curvature and supine posture

Sacral curvature (SC), represented by the angle between the first and the last sacral vertebrae, is a feature that differentiates the human pelvis from that of other animals. The sacral curvature was measured and studied in 14 cebids, 31 cercopithecids, 17 hylobatids, 85 pongids, 23 normal human children, 15 children with orthopedic handicaps, 49 normal adult human males, and 64 normal adult human females. Sacral curvature was minimal to nil in monkeys (mean 11.5 +/- 6 SD degrees), and moderate in apes (hylobatids, mean 16 +/- 10 SD degrees; pongids, mean 27.2 +/- 16 SD degrees). In human newborns SC is minimal, increasing progressively until adolescence, reaching a mean of 64.7 +/- 29 SD degrees in adult humans. This study investigates the different factors contributing to the formation of the sacral curvature. These factors include 1) the effect of erect posture, which tilts the upper part of the sacrum dorsally and the lower part of the sacrum ventrally, and 2) the influence of supine posture, which affects the development of the lower part of the sacrum. In addition to supine posture the levator ani, which is well developed in Homo sapiens, also affects the lower part of the sacrum and coccyx and influences its ventral orientation. Variation in SC can result from differences in onset and frequency of supine posture. This is the first time that supine posture has been shown to play a role in shaping the human pelvis, although it is as characteristic of H. sapiens as is erect posture.     

Prevalence of spina bifida occulta in patients with functional disorders of the lower urinary tract and its relation to urodynamic and neurophysiological measurements.

OBJECTIVE--To determine the relation between neurophysiological abnormalities and the radiological detection of spina bifida occulta in patients with dysfunction of the lower urinary tract. DESIGN--Blind assessment and subsequent decoding of mixed batch of abdominal radiographs from patients with and without urological symptoms for evidence of spina bifida occulta and comparison of results with those of previous control series. SETTING--Review study among tertiary referrals to an incontinence clinic of a city hospital. PATIENTS--One hundred and thirty eight adults with proved urodynamic abnormalities in whom neurophysiological measurements were available. INTERVENTIONS--None. END POINT--Correlation of neurophysiological abnormalities in lower urinary tract dysfunction with presence and type of spina bifida occulta and level of opening of posterior sacral arcs. MEASUREMENTS AND MAIN RESULTS--On decoding radiographs those from patients without urological symptoms showed a similar prevalence of spina bifida occulta to that in the control series (631/2707 controls; 23%). By contrast, patients with urological symptoms had a significantly increased prevalence of spina bifida occulta at S1 and S2 and a higher level of opening of posterior sacral arcs. The increased prevalence of the bony defect was particularly striking in men with urgency and instability and in women with stress incontinence. No significant correlation was found between any particular neurophysiological abnormality and the presence of spina bifida. CONCLUSIONS--In patients with dysfunction of the lower urinary tract neurophysiological abnormalities may be associated with congenital dysraphic lesions in the lower lumbar spine and sacrum. There appears to be no direct causal relation between the radiological and neurophysiological abnormalities but the findings suggest a common aetiological factor.     

Does postcranial palaeoneurology provide insight into pterosaur behaviour and lifestyle? New data from the azhdarchoid Vectidraco and the ornithocheirids Coloborhynchus and Anhanguera

The postcranial palaeoneurology of fossil reptiles is understudied, and those studies that exist focus predominantly on crocodyliforms and dinosaurs. The intervertebral foramina of the spine house nerves that exit to innervate surrounding tissues and the extremities. In the heavily fused (and typically distorted or poorly preserved) pterosaurian sacrum, intervertebral foramina can be difficult to observe and are rarely identified. The Early Cretaceous azhdarchoid Vectidraco from the Isle of Wight, UK, exhibits large, paired foramina on each sacral vertebra, originally identified as pneumatic foramina. Micro‐computed tomography imaging reveals these communicate with the neural canal and are intervertebral foramina for sacral nerves. The sacral vertebrae of Vectidraco are fused, and intervertebral foramina occur dorsolaterally on the centra. We identified these structures in other pterosaur sacra, including those of the ornithocheiroids Anhanguera and Coloborhynchus. The sizes of the sacral and notarial neural canals are compared and considered within interpretations of palaeoecology and locomotion, following previous studies. The relatively large sacral neural canal of Vectidraco implies a sacral enlargement for innervation of the legs and lumbosacral plexus. When compared with Anhanguera, this supports indications that azhdarchoids were more hindlimb‐proficient than ornithocheiroids. Neural canal size in the Coloborhynchus notarium suggests that ornithocheirids spent less time on the ground, their brachial enlargement and small sacral region indicating enhanced innervation of the wings and poor innervation of the sacrum and legs. This is the first study focusing on pterosaur postcranial palaeoneurology; more studies on other taxa are needed to reveal patterns across Pterosauria as a whole.     

Manual examination of so-called lumbosacral instability

By the manual test of the lumbosacral instability described by Eder and Tilscher we can never find out for certain whether the fifth lumbar vertebra can be shifted ventrally above the sacrum. Before this test the patient has to be turned over on to his side with hips flexed, which causes a ventral flexion (anteflexion) of the lumbosacral segment. During the test, however, the lumbosacral segment is forced to a dorsal flexion (retroflexion); therefore the spinous process of the fifth lumbar vertebra retires from the back surface simulating a sliding forward of the whole vertebra.     

Reevaluation of the lumbosacral region of Oreopithecus bambolii

Functional interpretations of the postcranium of the late Miocene ape Oreopithecus bambolii are controversial. The claim that Oreopithecus practiced habitual terrestrial bipedalism is partly based on restored postcranial remains originally recovered from Baccinello, Tuscany ( Köhler and Moyà-Solà, 1997). The lower lumbar vertebrae of BA#72 were cited as evidence that Oreopithecus exhibits features indicative of a lordotic lumbar spine, including dorsal wedging of the vertebral bodies and a caudally progressive increase in postzygapophyseal interfacet distance. Here, we demonstrate why the dorsal wedging index value obtained by Köhler and Moyà-Solà (1997) for the BA#72 last lumbar vertebra is questionable due to distortion in that region, present a more reliable way to measure postzygapophyseal interfacet distance, and include an additional metric (laminar width) with which to examine changes in the transverse dimensions of the neural arches. We also quantify the external morphology of the BA#72 proximal sacrum, which, despite well-documented links between sacral morphology and bipedal locomotion, and excellent preservation of the sacral prezygapophyses, first sacral vertebral body, and right ala, was not evaluated by Köhler and Moyà-Solà (1997). Measures of postzygapophyseal interfacet distance and laminar width on the penultimate and last lumbar vertebrae of BA#72 reveal a pattern encompassed within the range of living nonhuman hominoids and unlike that of modern humans, suggesting that Oreopithecus did not possess a lordotic lumbar spine. Results further show that the BA#72 sacrum exhibits relatively small prezygapophyseal articular facet surface areas and mediolaterally narrow alae compared with modern humans, indicating that the morphology of the Oreopithecus sacrum is incompatible with the functional demands of habitual bipedal stance and locomotion. The Oreopithecus lumbosacral region does not exhibit adaptations for habitual bipedal locomotion.     

Atlanto-occipital fusion and spondylolisthesis in an Anasazi skeleton from Bright Angel Ruin, Grand Canyon National Park, Arizona

The skeleton of a middle-aged female showing an unusual pattern of congenital, traumatic, and degenerative pathology was recovered from a small Kayenta Anasazi site located near the confluence of Bright Angel Creek with the Colorado River in the Inner Gorge of Grand Canyon. The atlas is fused with the base of the skull and C2 is fused with C3. The cervical region was subjected to hyperextension, perhaps through use of a tumpline, with resultant reduction of the neural canal to 8 mm, a condition that quite likely led to neurological problems. The skeleton also includes a depression fracture of the lateral condyle of the left tibia. Complete, bilateral spondylolysis of L5 led to an olisthesis of approximately 15 mm. The disc between L5 and S1 then ossified, most likely from staphylococcus bacteremia, making the olisthesis permanent and thereby creating a unique arachaeological specimen. Although spondylolysis is usually viewed as a stress fracture, the general pattern of pathology in this individual makes it necessary to consider an etiology of acute trauma.     

Evidence of Spondyloarthropathy in the Spine of a Phytosaur (Reptilia: Archosauriformes) from the Late Triassic of Halberstadt,Germany

Pathologies in the skeleton of phytosaurs, extinct archosauriform reptiles restricted to the Late Triassic, have only been rarely described. The only known postcranial pathologies of a phytosaur are two pairs of fused vertebrae of “Angistorhinopsis ruetimeyeri” from Halberstadt, Germany, as initially described by the paleontologist Friedrich von Huene. These pathologic vertebrae are redescribed in more detail in this study in the light of modern paleopathologic methods. Four different pathologic observations can be made in the vertebral column of this individual: 1) fusion of two thoracic vertebral bodies by new bone formation within the synovial membrane and articular capsule of the intervertebral joint; 2) fusion and conspicuous antero-posterior shortening of last presacral and first sacral vertebral bodies; 3) destruction and erosion of the anterior articular surface of the last presacral vertebra; and 4) a smooth depression on the ventral surface of the fused last presacral and first sacral vertebral bodies. Observations 1–3 can most plausibly and parsimoniously be attributed to one disease: spondyloarthropathy, an aseptic inflammatory process in which affected vertebrae show typical types of reactive new bone formation and erosion of subchondral bone. The kind of vertebral shortening present in the fused lumbosacral vertebrae suggests that the phytosaur acquired this disease in its early life. Observation 4, the smooth ventral depression in the fused lumbosacral vertebrae, is most probably not connected to the spondyloarthropathy, and can be regarded as a separate abnormality. It remains of uncertain origin, but may be the result of pressure, perhaps caused by a benign mass such as an aneurysm or cyst of unknown type. Reports of spondyloarthropathy in Paleozoic and Mesozoic reptiles are still exceptional, and our report of spondyloarthropathy in fossil material from Halberstadt is the first unequivocal occurrence of this disease in a Triassic tetrapod and in a phytosaur.     

Spondylolysis, spondylolisthesis, and lumbo-sacral morphology in a medieval English skeletal population

The prevalence of spondylolysis and spondylolisthesis was studied in an adult skeletal series from a rural English medieval archaeological site. Attempts were made to evaluate the association of three aspects of lumbo-sacral skeletal morphology (pelvic incidence (a measure of the anterior inclination of the sacral table), lumbar transverse process width, and the presence of lumbo-sacral spina bifida occulta) with spondylolysis and spondylolisthesis. Results indicated a high prevalence of spondylolysis compared with a modern reference population, but few cases of spondylolisthesis were identified. Analysis of prevalence with respect to age suggests that in the study population, pars interarticularis defects generally formed late in the growth period or early in adult life. The study group showed a high mean pelvic incidence compared with modern Western Europeans, indicating a more steeply inclined sacral table, which may have elevated the risk of developing pars interarticularis defects. However, no statistically valid association could be demonstrated between the presence/absence of spondylolysis and pelvic incidence in the study material. There was no evidence for a link between lumbar transverse process index or lumbo-sacral spina bifida occulta and spondylolysis/spondylolisthesis. It is concluded that the potential role of lumbo-sacral morphology, as well as of activity regimes, should be considered when interpreting spondylolysis in paleopathological studies. If the frequency of spondylolysis is to some extent an indicator of past activity regimes, it may reflect lifestyle in younger individuals rather than in mature adults. Further work investigating the link between spondylolysis and lumbo-sacral morphological variables in premodern populations would be of value.     

Measurement of soft tissue thickness over the sacrum of elderly hospital patients using B-mode ultrasound

The thickness of soft tissues over the sacrum of elderly hospital in-patients has been measured using B-mode ultrasound. Forty patients were scanned, of which nine had recognizable superficial pressure sores at the sacrum. No correlation was found between the depth of soft tissue and either age or Norton score. Patients with sores had less soft tissue over the sacrum (p < 0.025). Excluding one patient whose sacral sore appeared to be the final stage of the healing process, the remaining eight all had less than 8.5 mm of sacral soft tissue cover. Five patients without sacral sores also had less than 8.5 mm of sacral soft tissue cover. However, a combination of the presence of incontinence and the depth of sacral soft tissue cover identified seven of the eight patients with sacral sores with no inclusion of patients without sores.     

Fusion of coccyx to sacrum in humans: prevalence, correlates, and effect on pelvic size, with obstetrical and evolutionary implications

Humans do not have a tail, but we have four rudimentary coccygeal vertebrae. This study considers several issues pertaining to fusion of the coccyx to the sacrum, including prevalence, sexual differences, effect on pelvic size, and obstetrical and evolutionary implications. Previous research on sacral-coccygeal fusion has reported: (1) lower prevalence in females than males, (2) prevalence increases with age, (3) range in prevalence among 13 samples from 0 to 72%, and (4) obstetrical complications. This study uses a sample of 2,354 American skeletons of known sex, age 20 years and older to ascertain prevalence of sacral-coccygeal fusion and to evaluate some of its correlates. Results show that the sexes do not differ in prevalence of sacral-coccygeal fusion for five of seven decades of life, but that prevalence does increase with advancing age-from 24 to 47% from the third to eighth decades of life in females. Pelvimetric analysis of 132 females shows that those with sacral-coccygeal fusion have a shorter posterior sagittal diameter of the outlet compared to those without fusion; more than half of those with sacral-coccygeal fusion have an obstetrically contracted posterior sagittal diameter. Shortening of the posterior sagittal diameter is important, because its conjoint occurrence with a narrow subpubic arch may result in an obstetrically inadequate outlet. This study concludes that sacral-coccygeal fusion is a principal contributor to the evolution of sexual dimorphism in sacral angulation, which is a determinant of the length of the posterior sagittal diameter of the outlet.     

Can sacral marker approximate center of mass during gait and slip-fall recovery among community-dwelling older adults?

Falls are prevalent in older adults. Dynamic stability of body center of mass (COM) is critical for maintaining balance. A simple yet accurate tool to evaluate COM kinematics is essential to examine the COM stability. The purpose of this study was to determine the extent to which the COM position derived from body segmental analysis can be approximated by a single (sacral) marker during unperturbed (regular walking) and perturbed (gait-slip) gait. One hundred eighty seven older adults experienced an unexpected slip after approximately 10 regular walking trials. Two trials, the slip trial and the preceding regular walking trial, monitored with a motion capture system and force plates, were included in the present study. The COM positions were calculated by using the segmental analysis method wherein, the COM of all body segments was calculated to further estimate the body COM position. These body COM positions were then compared with those of the sacral marker placed at the second sacral vertebra for both trials. Results revealed that the COM positions were highly correlated with those of the sacrum׳s over the time intervals investigated for both walking (coefficient of correlation R>0.97) and slip (R>0.90) trials. There were detectable kinematic difference between the COM and the sacral for both trials. Our results indicated that the sacral marker can be used as a simple approximation of body COM for regular walking, and to somewhat a lesser extent, upon a slip. The benefits from the simplicity appear to overweigh the limitations in accuracy.