Skip to main content

Advertisement

Log in

Spinal dysraphism at the Syrian Neolithic site of Dja’de el-Mughara

  • Original Paper
  • Published:
Archaeological and Anthropological Sciences Aims and scope Submit manuscript

Abstract

Spina bifida is a neurulation defect that results in an incomplete closing of the backbone, as well as membranes surrounding the spinal cord. Several archaeological cases of spina bifida have been reported, remarkably during the Bronze Age and Classic Era. However, few prehistoric cases have been recovered, with the exception of the important Epipaleolithic Iberomaurusian site of Taforalt (Morocco). This article describes the first case of a spina bifida condition during the Neolithic of Near East, at the Syrian site of Dja-de el-Mughara. Although at the onset of the Syrian civil war, image record has enabled the description of a complete spina bifida case. Two other possible cases have not been confirmed, since it was impossible to reevaluate the osteological material hosted at the field laboratory in Dja-de el-Mughara. However, due to the low incidence of this neural tube disorder (NTD), we argue that it could be associated to a genetic disorder rather than to environmental factors such as arsenic intake or a deficient diet.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Andrew J. Copp, N. Scott Adzick, … Gary M. Shaw

References

  • Albrecht TL, Scutter SD, Henneberg M (2007) Radiographic method to assess the prevalence of sacral spina bifida occulta. Clin Anat 20:170–174

    Google Scholar 

  • Alfonso-Durruty MP, Morello F, Calás E (2011) The etiology of porotic hyperostosis and spina bifida oculta in a high latitude hunter-gatherers. AJPA 114(Suppl. 52):73

    Google Scholar 

  • Alles AJ, Sulik KK (1990) Retinoic acid-induced spina bífida: evidence for a pathogenetic mechanism. Development 108:73–81

    Google Scholar 

  • Antony AC (2003) Vegetarianism and vitamin B-12 (cobalamin) deficiency (2003). Am J Clin Nutr 78:3–6

    Google Scholar 

  • Armstrong SD (2012) Spina bifida at a pre-Columbian Cuban site: a molecular and paleoepidemiological perspective. Dissertation, University of Manitoba

  • Armstrong S, Cloutier L, Arredondo C, Roksandic M, Matheson C (2013) Spina bifida in a pre-Columbian Cuban population: a paleoepidemiological study of genetic and dietary risk factors. Int J Paleopathology 3:19–29

    Google Scholar 

  • Au KS, Ashley-Koch A, Northrup H (2010) Epidemiologic and genetic aspects of spina bifida and other neural tube defects. Dev Disab Res Rev 16(1):6–15

    Google Scholar 

  • Aufderheide AC, Rodríguez-Martín C (1998) Human paleopathology. Cambridge University Press, Cambridge

    Google Scholar 

  • Avrahami E, Frishman E, Fridman Z, Azor M (1994) Spina bifida occulta of S1 is not an innocent finding. Spine (Phila Pa 1976) 19(1):12–15

    Google Scholar 

  • Baker O, Lee OYC, Wu HHT, Besra GS, Minnikin DE, Llewellyn G, Williams CM, Maixner F, O’Sullivan N, Zink A, Chamel B, Khawam R, Coqueugniot E, Helmer N, Le Mort F, Perrin P, Gourichon L, Dutailly B (2015) Human tuberculosis predates domestication in ancient Syria. Tuberculosis 95:S4–S12

    Google Scholar 

  • Barringer JL, Reilly PA (2006) Chapter 4: arsenic in groundwater: a summary of sources and the biogeochemical and hydrogeologic factors affecting arsenic occurrence and mobility. In: Bradley PM (ed) Current perspectives in contaminant hydrology and water resources sustainability. InTech, Rijeka (Croatia), pp 83–116

    Google Scholar 

  • Barf HA, Verhoef M, Jennekens-Schinkel A, Post MWM, Gooskens RHJM, Prevo AJH (2003) Cognitive status of young adults with spina bífida. Dev Med Child Neurol 45:813–820

    Google Scholar 

  • Bellinger DC (2005) Teratogen update: lead and pregnancy. Birth defects res. A: Clin Mol Teratol 73:409–420

    Google Scholar 

  • Berry AC (1975) Factors affecting the incidence of non-metrical skeletal variants. J Anat 120(3):519–535

    Google Scholar 

  • Boulet SL, Yang Q, Mai C, Kirby RS, Collins JS, Robbins JM (2008) Trends in the postfortification prevalence of spina bifida and anencephaly in the United States. Birth Defects Res (Part A) 82:527–532

    Google Scholar 

  • Black MM (2008) Effects of vitamin B12 and folate deficiency on brain development in children. Food Nutr Bull 29(2):126–131

    Google Scholar 

  • Bradai R, Robert E (1998) Prenatal ultrasonographic diagnosis in the epileptic mother on valproic acid. Retrospective study of 161 cases in the central eastern France register of congenital malformations. J Gynecol Obstet Biolo Reprod (Paris) 27:413–419

    Google Scholar 

  • Brailsford JF (1953) The radiology of bones and joints. J & A Churchill, London

    Google Scholar 

  • Campillo Álvarez E (2009) Paleopatologías en aborígenes cubanos del sitio arqueológico Canímar Abajo, Matanzas, Cuba. MA thesis, University of Havana, Havana

  • Casella EB, Valente M, Medeiros de Navarro J, Kok F (2005) Vitamin B12 deficiency in infancy as a cause of development regression. Brain Dev 27:592–594

    Google Scholar 

  • Castro M (2004) Arsénico en el agua de bebida de América Latina y su efecto en la salud pública. Hojas de Divulgación Técnica HDT - CEPIS 95:1–12

    Google Scholar 

  • Ceylan S, Duru S, Ceylan S (2001) Valproic acid sodium-induced bífida occulta in the rat. Neurosurg Rev 24:31–34

    Google Scholar 

  • Christidou R, Coqueugniot E, Gourichon L (2009) Neolithic figurines manufactured from phalanges of equids from Dja’de el Mughara, Syria. J Field Archaeol 34(3):319–335

    Google Scholar 

  • Chamel B (2014) Bioanthropologie et pratiques funéraires des populations néolithiques du Proche-Orient: l’impact de la Néolithisation (Étude de sept sites syriens (9820–6000 cal. BC). Biological anthropology. Dissertation, Université Lumiére Lyon 2

  • Chen CP (2008) Syndromes, disorders and maternal risk factors associated with neural tube defects (I). Taiwan J Obstet Gynecol 47(1):1–9

    Google Scholar 

  • Cockburn A, Cockburn E, Reyman TA (1998) Mummies, Disease & Ancient Cultures. Cambridge University Press, UK

    Google Scholar 

  • Connely J, Colledge S, Dobney K, Vigne JD, Peters J, Stopp B, Manning K, Shennan S (2011) Meta-analysis of zooarchaeological data from SW Asia and SE Europe providesinsight into the origins and spread of animal husbandry. J Archaeol Sci 38:538–545

    Google Scholar 

  • Coqueugniot E (1998) Djade el Mughara (Moyen-Euphrate), un village néolithique dans son environnement naturel à la veille de la domestication. In: Fortin M, Aurenche O (eds.) Espace naturel, espace habité en Syrie du Nord (10e-2e millénaires av. J.C.). Canadian Society for Mesopotamian Studies/Lyon: Maison de l’Orient méditerranéen, pp 109–114

  • Coqueugniot E (2000) Dja’de (Syrie), un village à la veille de la domestication(seconde moitié du 9e millénaire av. J.C.). In: Guilaine J (ed) Les premiers paysans du monde, naissance des agricultures. Errance, Paris, pp 63–79

    Google Scholar 

  • Coqueugniot H, Dutailly B, Desbarats P, Boulestin B, Pap I, Szikossy I, Baker O, Montaudon M, Panuel M, Karlinger K, Kovács B, Kristóf LA, Pálfi G, Dutour O (2015) Three-dimensional imaging of past skeletal TB: from lesion to process. Tuberculosis 95(1):73–79

    Google Scholar 

  • Cornejo-Ponce L, Acarapi-Cartes J (2011) Fractionation and bioavailability of arsenic in agricultural soils: solvent extraction tests and their relevance in risk assessment. J Environ Sci Health, Part A: Toxic/Hazard. Subst Environ Eng 46:1247–1258

    Google Scholar 

  • Cornejo-Ponce L, Lienqueo HH, Arriaza BT (2011) Levels of total arsenic in edible fish and shellfish obtained from two coastal sectors of the Atacama Desert in the north of Chile: use of non-migratory marine species as bioindicators of sea environmental pollution. J Environ Sci Health, Part A: Toxic/Hazard. Subst Environ Eng 46:1274–1282

    Google Scholar 

  • Danrey V (2000) Dja’de el-Mughara 2000, secterur B. In: E. Coqueugniot (Dir.), Cahiers de fouilles de Dja’de el-Mughara. Archivés at Archéorient, n.p.

  • Desmeulles V (2001) Les pratiques funéraires du PPNB ancient de Syrie. Étude de cas: Dja’de el Mughara. Master Disertation, Paris. Université de Paris 1 Panthéon-Sorbonne. Archéologie du Proche-Prient

  • Dickel DN, Doran GH (1989) Severe neural tube defect syndrome from the early archaic of Florida. Am J Phys Anthrop 80(3):325–334

    Google Scholar 

  • Djurić M, Janović A, Milanović P, Djukić K, Milenković P, Drašković RM (2010) Adolescent health in medieval Serbia: signs of infectious diseases and risk of trauma. Homo –J Comp Human Biol 61:130–149

    Google Scholar 

  • Douglas K (1993) The great folic acid scandal. New Sci 139(1882):24–25

    Google Scholar 

  • Dweivedi AK, Bhatnagar R (2016) Anthropometric study of angle of femoral torsion in Maharashtrian population. Medical Journal of Dr. D.Y. Patil University 9(2):200–203

    Google Scholar 

  • Ehlers K, Elmazar MMA, Nau H (1996) Methionine reduces the valproic acid-induced spina bifida rate in mice without altering valproic acid kinetics. J Nutr 126:67–75

    Google Scholar 

  • Estebaranz F, Anfruns J (2006) Informe sobre el material antropológico del yacimiento neolítico de Dja’de, Siria. Archaeological Report (not published)

  • Estebaranz F, Martinez LM, Anfruns J, Pérez-Pérez A (2007) Short fieldwork report: tell Halula (Syria), seasons 1992-2005. Bioarchaeology of the Near East 1:65–67

    Google Scholar 

  • Ferembach D (1963) Frequeny of spina bifida occulta in prehistoric human skeletons. Nature 199:100–101

    Google Scholar 

  • Fidas A, MacDonald HL, Elton RA, McInnes A, Wild SR, Chrisholm GD (1989) Prevalence of spina bifida occulta in patients with functional disorders of the lower urinary tract and its relation to urodynamic and neurophysiological measurements. BMJ 298:357–359

    Google Scholar 

  • Gelineau-van Waes J, Finnel RH (2001) Gentics of neural tube defects. Sem Pediat Neurol 8(3):160–164

    Google Scholar 

  • Gordon N (1995) Folate metabolism and neural tube. Brain Dev 17:307–311

    Google Scholar 

  • Graham HK, Parsch K (2009) Neural tube defects, spina bifida, and spinal dysraphism. In: Benson M, Fixsen J, Macnicol M, Parsch K (eds) Children’s orthopaedics and fractures. Springer, London, pp 265–286

    Google Scholar 

  • Groza VM, Simalcsik A, Bejenaru L (2013) Spina bífida occulta in Medieval and Post-Medieval skeletons from Iasi city, in north-east Romania. Analele Științifice ale Universității “Alexandru Ioan Cuza” din Iași, s. Biologie animală LIX:101–113

    Google Scholar 

  • Guez S, Chiarelli G, Menni F, Salera S, Principi N, Esposito S (2012) Severe vitamin B12 deficiency in an exclusivelybreastfed 5-month-old Italian infant born to amother receiving multivitamin supplementationduring pregnancy. BMC Pediatr 12:85–90

    Google Scholar 

  • Guidotti TL (1978) American Indian anthropology and medicine. J Am Med Assoc 240:348

    Google Scholar 

  • Hall JG (1986) Neural tube defects, sex ratios, and X inactivation. Lancet 6(2):1334–1335

    Google Scholar 

  • Hall AH (2002) Chronic arsenic poisoning. Toxicol Lett 128:69–72

    Google Scholar 

  • Hartel M, Petersik A, Schmidt A, Kendoff D, Nüchtern J, Rueger JM, Lehmann W, Grossterlinden LG (2016) Determination of femoral neck angle and torsion angle utilizing a novel three-dimensional modeling and analytical technology based on CT datasets. PLoS One. doi:10.1371/journal.pone.0149480

    Google Scholar 

  • Henneberg RJ, Henneberg M (1999) Variation in the closure of the sacral canal in the skeletal sample from Pompeii, Italy, 79 AD. Perspect Human Biol 4(1):177–188

    Google Scholar 

  • Herrerín J, Baxarias J, Garcia-Guixé E, Núñez M, Dinarés R (2010) Betatalasemia en un niño de una necrópolis del Imperio Nuevo (Luxor, Egipto). Estudio macroscópico y radiológico. Imagen Diagn 1(2):61–66

    Google Scholar 

  • Herrmann W, Schorr H, Obeid R, Geisel J (2003) Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and hyperhomocysteinemia in vegetarians. Am J Clin Nutr 78:131–136

    Google Scholar 

  • Honein MA, Paulozzi LJ, Mathews TJ, Erickson JD, Wong LY (2001) Impact of folic acid fortification of the US food supply on the Ocurrence of neural tube defects. JAMA 285:2981–2986

    Google Scholar 

  • Józca L, Pap I, Fóthi E (1992) The occurrence of spina bifida occulta in medieval and contemporaneous Hungarian populations. Anthropologia Hungarica XXIL:57–60

    Google Scholar 

  • Kajbafzadeh A, Espandar L, Mehdizadeh M, Tajik P, Mohseni P (2004) Spina bifida occulta in persistent primary nocturnal enuresis. Iran J Radiol December:65–67

  • Kendrew Quadrangle Excavations (2008) Phase 3- Mass Burial Pathology. January–August

  • Kenyon K (1957) Digging up Jericho. Benn, London

    Google Scholar 

  • Keshavarzi B, Moore F, Mosaferi M, Rahmani F (2011) The source of natural arsenic contamination in groundwater, west of Iran. Water Qual Expo Health 3:135–147

    Google Scholar 

  • Kibar Z, Capra V, Gros P (2007) Towards understanding the genetic basis of neural tube defects. Clin Genet 71:295–310

    Google Scholar 

  • Kingsley PC, Olmsted KL (1948) A study to determine the angle of anteversion of the neck of the femur. J Bone Joint Surg Am 30A:745–751

    Google Scholar 

  • Kozma C (2008) Skeletal dysplasia in ancient Egypt. Am J Med Genet A 146A:3104–3112

    Google Scholar 

  • Kubavat DM, Nagar SK, Varlekar P, Uttekar K, Kumar SV, Lakhani C (2013) A study of Total spina bifida of the sacrum in western India. Int J Rec Trends Sci Tech 7(1):10–13

    Google Scholar 

  • Kumar A, Tubbs RS (2011) Spina bifida: a diagnostic dilemma in paleopathology. Clin Anat 14:19–33

    Google Scholar 

  • Kumar P, Aneja S, Kumar R, Taluja V (2005) Spina bifida occulta in functional enuresis. Indian J Pediatrics 72:223–225

    Google Scholar 

  • Kuttner RE (1978) Prehistoric Spina Bifida Occulta. JAMA 240:24

    Google Scholar 

  • Lassmann J, Garibay Gonzalez F, Melchionni JB, Pasquariello PS, Snyder HM III (2007) Sexual function in adult patients with spina bifida and its impact on quality of life. J Urol 178:1611–1614

    Google Scholar 

  • Laurence KM, James N, Miller M, Campbell H (1980) Increased risk of recurrence of pregnancy complicated by fetal neural tube defects in mothers receiving poor diets, and possible benefit of dietary counseling. Br Med J 281:1592–1594

    Google Scholar 

  • Laurence KM, James N, Miller M, Tennent GB, Campbell H (1981) Double-blind randomized controlled trials of folate treatment before conception to prevent recurrence of neural tube defects. Br Med J 282:1509–1511

    Google Scholar 

  • Le Mort F (2007) Développements récents dans l’étude des premières populations néolithiques du Proche-Orient. Bulletin du Centre de recherche français à Jerusalem 18:20–35

    Google Scholar 

  • Lin HM, Lee KX, Yeh MC, Chen CC, Lai HC, Liao MT, Chen SF (2014) The pathology and dental morphology of Neolithic burials from the Wu-Shan-Tou site, southwestern Taiwan. J Archaeol Anthrop 80:251–282

    Google Scholar 

  • Lindhout D, Meinardi H (1984) Spina bífida and in utero exposure to valproate. Lancet II:396

    Google Scholar 

  • Maat GJR, Lonnee HA, Noordhuizen HJW (1990) Analysis of human skeletons from the Hellenistic period, buriedat a ruined Bronz.e age building on Failaka, Kuwait. In: Failaka, fouilles françaises 1986–1988. Sous la direction de YvesCalvet et Jeacqueline Gachet. Lyon: Maison de l’Orient et de la Méditerranée Jean Pouilloux pp. 85–102

  • Maddin R, Stech T, Muhly JD (1991) Çayönü Tepesi. The earliest archaeological metal artifacts. In: Mohen JP, Eluère C (eds) Découverte du Métal. Mediterranée oriental et Proche-Orient, Paris, pp 375–386

    Google Scholar 

  • Makarewicz C, Tuross N (2012) Finding fodder and tracking transhumance: isotopic detection of goat domestication Processess in the near east. Curr Anthrop 53(4):495–505

    Google Scholar 

  • Marani E, Koch WFRM (2014) The pelvis: Structre, gender and society. Springer-Verlag, Dordrecht

    Google Scholar 

  • Markowska A (2007) Anthropological analysis of human skeletal remains from a modern cemetery in Wyszyński street in Wrocław, Poland. EAA Summer School eBook 1:65–81

    Google Scholar 

  • Martini F, Ober WC (2001) Fundamentals of anatomy and physiology: prentice hall. Englewood Cliffs, New Jersey

    Google Scholar 

  • Masson M (2014) The Osteological Evidence of Neolithic Populations from the Southern Great Plain of Hungary: An Insight into the Potential of Macroscopic Observations for the Demographic and Pathological Analyses of Past Populations. Dissertation, University of Szeged

  • Miyazato M, Sugaya K, Nishijima S, Owan T, Ogawa Y (2007) Location of spina bifida occulta and ultrasonographic bladder abnormalities predict the outcome of treatment for primary nocturnal enuresis in children. Int J Urol 14:33–38

    Google Scholar 

  • Mitchell LE, Adzick NS, Melchionne J, Pasquariello PS, Sutton LN, Whitehead AS (2004) Spina bifida. Lancet 364:1885–1895

    Google Scholar 

  • Molist M, Montero-Ruiz I, Clops X, Rovira E, Guerrero E, Anfruns J (2010) New metallurgic findings from the pre-pottery Neolithic: tell Halula (Euphrates Valley, Syria). Paléorient 35:33–48

    Google Scholar 

  • Molloy AM (2005) The role of folic acid in the prevention of neural tube defects. Trends Food Sci Technol 16:241–245

    Google Scholar 

  • Mrudula C, Naveena S (2013) Morphometry of sacral hiatus and its clinical relevance. Int J Adv Res 1(7):12–18

    Google Scholar 

  • Naderi S, Rezaei HR, Pompanon F, Blum MGB, Negrini R, Naghash HR, Balkiz Ö, Mashkour M, Gaggiotti OE, Ajmone-Marsoan P, Vigne JF, Taberlet P (2008) The goat domestication process inferred from large-scale mitochondrial DNA analysis of wild and domestic individuals. PNAS 105(46):17659–17664

    Google Scholar 

  • Nagar SK (2004) A study of sacral hiatus in dry human sacra. J Anat Soc India 54(2):18–21

    Google Scholar 

  • Nagar Y (2011) Human osteological database at the Israel antiquities authority. Overview and some examples of use. Bioarchaeology of the Near East 5:1–18

    Google Scholar 

  • Northrup H, Volcik KA (2000) Spina Biffida and other neural tube defects. Curr Probl Pediatr 30(10):317–322

    Google Scholar 

  • Ortner DJ (2003) Identification of Pathological Conditions in Human Skeletal Remains. 2nd Edition. Academic Press, San Diego (USA) Page 469

  • Ostendorf Smith M (2012) Paleopathology. In: DiGangi EA, Moore MK (eds) Research methods in human skeletal biology. Academic Press, Oxford

    Google Scholar 

  • Pales L (1930) Paléopathologie et pathologie comparative. Masson Ed, Paris

  • Palmer JS, Kaplan WE, Firlit CF (1999) Erectile dysfunction in spina bifida is treatable. Lancet 354:125–126

    Google Scholar 

  • Palmer JS, Kaplan WE, Firlit CF (2000) Erectile dysfunction in patients with spina bifida is a treatable condition. J of Urol 164:958–961

    Google Scholar 

  • Park CH, Stewart W, Khoury MJ, Mulinare J (1992) Is there etiologic heterogeneity between upper and lower neural tube defects. Am J Epidemiol 136:1493–1501

    Google Scholar 

  • Parsons FG (1914) The characters of the English thigh-bone. J Anat Physiol XLVIII:238–267

    Google Scholar 

  • Payne J, Shibasaki F, Mercola M (1997) Spina bifida occulta in homozygous Patch mouse embryos. Dev Dyn 209:105–116

    Google Scholar 

  • Pollard AM, Ditchfield P, Piva E, Wallis S, Falys C, Ford S (2012) Sprounting like cockle amongst the wheat: the St. Brice’s day massacre and the isotopic analysis of human bones from St. John’s college, Oxford. Oxford J Arch 31(1):83–102

    Google Scholar 

  • Rachmel A, Steinberg T, Ashkenazi S, Sela BA (2003) Cobalamin deficiency in a breast-fed infant of a vegetarian mother. IMAJ 5:534–536

    Google Scholar 

  • Reikerås O, Bjerkreim I, Kolbenstvedt A (1983) Anteversion of the acetabulum and femoral neck in Normals and in patients with osteoarthritis of the hip. Acta Orthopaedica Scan 54(1):18–23

    Google Scholar 

  • Rife JL (2012) Isthmia. Excavations by the University of California at Los Angeles and the Ohio State University under the auspices of the American School of Classical Studies at Athens. Volume IX. The Roman and Byzantine graves and human remains. The American School of Classical Studies at Athens Princeton, New Jersey

  • Roberts C, Manchester K (2005) The archaeology of disease. Cornell University Press, Ithaca

    Google Scholar 

  • Ronis MJ, Aronson J, Gao GG, Hogue W, Skinner RA, Badger TM, Lumpkin CK Jr (2001) Skeletal effects of developmental lead exposure in rats. Toxicol Sci 62:321–329

    Google Scholar 

  • Sairyo K, Goel VK, Vadapalli S, Vishnubhotla SL, Biyani A, Ebraheim N, Terai T, Sakai T (2006) Biomechanical comparison of lumbar spine with or without spina bifida occulta. A finite element analysis. Spinal Cord 44:440–444

    Google Scholar 

  • Sakakibara R, Hattori T, Uchiyama T, Kamura K, Yamanishi T (2003) Uroneurological assessment of spina bifida cystica and occulta. Neurourol Urodyn 22:328–334

    Google Scholar 

  • Saluja PG (1988) The incidence of spina bifida occulta in a historic and modern London population. J Anat 158:91–93

    Google Scholar 

  • Savona-Ventura C (2007) Congenital malformations: a historical perspective in a Mediterranean community. Malta Med J 19(1):52–55

    Google Scholar 

  • Seaver LH, Stevenson RE (2006) Syndromes with neural tube defects. In: Wyszynski DF (ed) Neural tube defects: from origin to treatment. Oxford University Press, Oxford, pp 76–83

    Google Scholar 

  • Seema SM, Mahajan A (2013) An Anatomical Study of Variations of Sacral Hiatus in Sacra of North Indian Origin and Its Clinical Significance. Estudio Anatómico de las Variaciones del Hiato Sacro en Sacros del Norte de la India y su Significancia Clínica. Int J Morphol 31(1):110–114

    Google Scholar 

  • Senoglu N, Senolgu M, Oksuz H, Gumusalan Y, Yuksel KZ, Zencirci B, Ezberci M, Kizilkanat E (2005) Landmarks of the sacral hiatus for caudal epidural block:an anatomical study. British J of Anaesthesia 95(5):692–695

    Google Scholar 

  • Shin SH, Im YJ, Lee MJ, Lee YS, Choi EK, Han SW (2013) Spina bifida occulta: not to be overlooked in children with nocturnal enuresis. Int J Urol 20:831–835

    Google Scholar 

  • Silva-Pinto V, Arriaza B, Standen V (2010) Evaluación de la frecuencia de espina bífida oculta y su posible relación con el arsénico ambiental en una muestra prehispánica de la Quebrada de Camarones, norte de Chile. Rev Med Chile 138:461–469

    Google Scholar 

  • Simalcsik A, Miu G, Groza VM, SImalcsik RD (2011) Regarding occult Spinal Dysreaphism (Spina Bifida Ocuulta), focusing especially on a Medieval population from Iaşi. Analele Științifice ale Universității “Al. I. Cuza” Iași, s. Biologie animală LVII:131–140

    Google Scholar 

  • Simsek C (2013) Assessment of naturally ocurring arsenic contamination in the groundwater of Sarkisla plain (Sivas/Turkey). Environ Earth Sci 68:691–702

    Google Scholar 

  • Singh R (2013) Classification, causes and clinical implications of sacral spina bifida occulta in Indians. Basic Sciences of Medicine 2(1):14–20

    Google Scholar 

  • Smrcka V, Horn V, Salas M, Loosova J (1989) Porous hyperostosis and signs of cannibalism at the Blucina locality in southern Moravia (Czechoslovakia) in the early bronze age. PaleoBios 5(1):5–15

    Google Scholar 

  • Spacca B, Buxton N (2008) Spina bifida occulta and monozygotic twins. J Neurosurg Pediatrics 2:258–260

    Google Scholar 

  • Swift J, Cupper ML, Creig A, Westaway MC, Carter C, Santoro CM, Wood R, Jacobsen GE, Bertuch F (2015) Skeletal arsenic of the pre-Columbian population of Caleta Vitor, northern Chile. J Archaeol Sci 58:31–45

    Google Scholar 

  • Taskaynatan MA, Izci Y, Ozgul A, Hazneci B, Dursun H, Kalyon TA (2005) Clinical significance of congenital lumbosacral malformations in young male population with prolonged low back pain. Spine 30(8):210–213

    Google Scholar 

  • Tchounwou PB, Centeno JA, Patlolla AK (2004) Arsenic toxicity, mutagenesis, and carcinogenesis –a health risk assessment and management approach. Mol Cell Biochem 255:47–55

    Google Scholar 

  • Tchounwou PB, Patlolla AK, Centeno JA (2003) Carcinogenic and systemic health effects associated with arsenic exposure –a critical review. Toxicol Pathol 31:575–588

    Google Scholar 

  • Toogood PA, Skalak A, Cooperman DR (2009) Proximal femoral anatomy in the normal human population. Clin Orthop Relat Res 467:876–885

    Google Scholar 

  • Van der Put NMJ, Trijbels FJM, van den Heuvel LP, Blom HJ, Steegers-Theunissen RPM, Eskes TKAB, Mariman ECM, den Heyer M, Frosst P, Rozen R (1995) Mutated methylenetetrahydrofolate reductase as a risk factor for spina bifida. Lancet 346(8982):1070–1071

    Google Scholar 

  • Van Winckel M, Vande Velde S, De Bruyne R, Van Biervliet S (2011) Clinical practice: vegetarian infant and child nutrition. Eur J Pediatr 170:1489–1494

    Google Scholar 

  • Verhoef M, Barf HA, Post MWM, van Asbeck FWA, Gooskens RHJM, Prevo AJH (2004) Secondary impairments in young adults with spina bífida. Developmental Medicine & Child Neurology 46:420–427

    Google Scholar 

  • Verhoef M, Post MWM, Barf HA, van Asbeck FWA, Gooskens RHJM, Prevo AJH (2007) Perceived health in young adults with spina bífida. Developmental Medicine & Child Neurology 49:192–197

    Google Scholar 

  • Vigne JD (2008) Zooarchaeological Aspects of the Neolithic Diet Transition in the Near East and Europe, and Their Putative Relationships with the Neolithic Demographic Transition. In: Bocquet-Appel JP, Bar-Yosef O (ed) The Neolithic Demographic Transition and its Consequences, Springer Science & Business Media, pp 179–205.

  • Walker PL, Bathurst RR, Richman R, Gjerdrum T, Andrushko VA (2009) The causes of porotic hyperostosis and cribra orbitalia: a reappraisal of the iron-deficiency-anemia hypothesis. Am J Phys Anthrop 139:109–125

    Google Scholar 

  • Watkins ML, Scanlon KS, Mulinare J, Khoury MJ (1996) Is maternal obesity a risk factor for anencephaly and spina bifida? Epidemiology 7(5):507–512

    Google Scholar 

  • Weiss G, Goodnough LT (2005) Anemia of chronic disease. N Engl J Med 352:1011–1023

    Google Scholar 

  • Weiss R, Fogelman Y, Bennet M (2004) Severe vitamin B12 deficiency in an infant associated with a maternal deficiency and a strict vegetarian diet. J Pedriatic Hematology/Oncology 26(4):270–271

    Google Scholar 

  • Wilson A, Platt R, Wu Q, Leclerc D, Christensen B, Yang H, Gravel RA, Rozen R (1999) A common variant in methionine synthase reductase combined with low cobalamin (vitamin B12) increases risk for spina bifida. Mol Genet Metabol 67(4):317–323

    Google Scholar 

  • Williams LJ, Mai CT, Edmonds LD, Shaw GM, Kirby RS, Hobbs CA, Sever LE, Miller LA, Meankey FJ, Levitt M (2002) Prevalence of spina bifida and anencephaly during the transition to mandatory folic acid fortification in the United States. Teratology 66:33–39

    Google Scholar 

  • Werler MM, Shapiro S, Mitchell AA (1993) Periconceptional folic acid exposure and risk of occurrent neural tube defects. J Am Med Assoc 269:1257–1261

    Google Scholar 

  • Yalçin Ü, Pernicka E. (1995) Frühneolithische Kupfermetallurgie von Aşikli Höyük n.d. In: Hauptmann A, Pernicka A, Rehren T & Yalçin (ed) The Beginnings of Metallurgy. Proceedings of the International Conference “The Beginnings of Metallurgy”, Bochum pp 45–55

  • Zeder MA, Hesse B (2000) The initial domestication of goats (Capra hircus) in the Zagros Mountains 10,000 Years ago. Science 287:2254–2257

    Google Scholar 

  • Zemerline A, Vincent JP, Sid-Ahmed S, Le Nen D, Dubrana F (2012) Lumbo-sacral malformations and spina bifida occulta in medieval skeletons from Brittany. Eur J Orthop Surg Traumatol. doi:10.1007/s00590-012-0967-2

    Google Scholar 

Download references

Acknowledgements

This article was funded by a travel grant associated to the FPU grant from the Spanish Government to Ferran Estebaranz-Sánchez. We are grateful to all the members of the Archaeological Spanish Mission to Tell Halula, especially to Josep Anfruns and Anna Gómez, as well as the members of the French Archaeological Mission to Dja’de el-Mighara, especially to Rima Khawam and Hala Alarashi. Finally, we must express our heartfelt admiration for Mohammad Ali, the government responsible of the site, who, despite the onset of the war, has been concerned about the future of the site.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to F. Estebaranz-Sánchez.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Estebaranz-Sánchez, F., Martínez, L.M., Alrousan, M. et al. Spinal dysraphism at the Syrian Neolithic site of Dja’de el-Mughara. Archaeol Anthropol Sci 10, 1375–1387 (2018). https://doi.org/10.1007/s12520-016-0460-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12520-016-0460-7

Keywords

Navigation