Avulsion injuries of vertebral endplates

Bone changes resulting from avulsions involving vertebral endplates have had little, if any, systematic attention in palaeopathological literature. To gain insight into their occurrence and into their variety, two archaeological skeletal collections covering the period AD 1455–1824 were examined. Additional skeletal material was used to illustrate typical examples. A quarter of the 44 adults who had adequate numbers of vertebrae at all spinal levels showed minor to major vertebral endplate changes as a result of avulsion injuries. The male/female ratio was 7:4. The ratio of individuals with injuries contracted during their youth and during their adulthood was 3:8 ( n =11). Approximately half of the affected individuals showed such changes in multiple vertebrae. In about one third of the cases, concomitant vertebral fractures, which did not involve the endplates, were recorded. Since the existing classifications of endplate changes from avulsion injuries were developed on the basis of clinical diagnoses made by means of X‐ray or by autopsy, an adapted and extended outline for palaeopathological use is proposed. A series of differential diagnoses is discussed. Although, in general, the poor preservation of archaeological spines hampers epidemiology, the diagnosis of spinal avulsion injuries offers interesting information at the individual level. Copyright © 2000 John Wiley & Sons, Ltd.