Background Data: Vitamin D deficiency compromises bone mineralization and may predispose individuals to spinal deformities. A holistic understanding of the effects of deficiency on the spine should be explored. Historical skeletal samples provide unique evidence for long-term interactions between biocultural influences and spinal health, which can be applied in a clinical setting. The objective of this project was to assess whether vitamin D deficiency was associated with idiopathic and degenerative spinal pathologies in a late 19th through early 20th century skeletal sample. Methods: A total of 177 adults remains were examined for evidence of vitamin D deficiency and vertebral compression patterns associated with kyphosis, lordosis, scoliosis, and Schmorl's nodes (SN). Macroscopic analysis revealed vitamin D deficiency, SN, spondylolysis, and spondylolisthesis. An adapted Genant semiquantitative technique was used to calculate compression fracture scores. A 10% grade of two or more adjacent vertebrae denotes compression fracture pathology. Skeletal data were compared with biocultural data extracted from the historical record, and associations were tested using chi-square and binary logistic regression. Results: Residual rickets (10.7%) and osteomalacia (7.3%) were present in the sample. Spinal pathology occurred in 72.9% of individuals. Vitamin D deficiency was significantly associated with kyphosis (p = 0.03), lordosis (OR: >9; p < 0.05), and scoliosis (OR: 3.39; p < 0.001). Occupational stress and sex also affected these relationships. Lordosis was more common in women with domestic work histories, while scoliosis was more prevalent in male laborers. SN were frequent but demonstrated stronger associations with occupation than with vitamin D status. Conclusion: Everyone's unique biocultural variables influence vitamin D status, while both vitamin D levels and confounding variables impact spinal pathology expression. These findings support a multifactorial model in which nutritional deficiency and occupational stress jointly shape vertebral health, underscoring the need for further clinical and paleopathological research on vitamin D status and spinal pathology.
Kristy Henson (Fri,) studied this question.