Download The Backbone of Moche Society: Spinal Degenerative Joint Disease

The Backbone of Moche Society:
Spinal Degenerative Joint Disease and Differentiating Social
Stratification at San Jose de More, Peru
BY
Matthew C. Go
A thesis submitted in partial fulfillment of the requirements for
the degree of
BACHELOR OF ARTS HONOURS
in the
Department of Archaeology
© Matthew C. Go 2013
SIMON FRASER UNIVERSITY
Fall 2013
ABSTRACT
This investigation seeks to explore variation in the quality of life among Late Moche
individuals at San Jose de Moro, Peru, as reflected in the severity of spinal degenerative joint
disease (SDJD). San Jose de Moro is a protected archaeological site located on the north coast of
Peru. Prehistoric occupation spans from the Middle Moche Period (AD 100) until Chimu-Inca
times. However, the focus of this research is the Late Moche Period (AD 700-800).
Spinal degenerative joint disease in the skeletal remains is used as an indicator of the
relative quality of life the individual had endured. The vertebral elements were examined at
several spinal joints for lesions indicative of SDJD including marginal osteophytes, lipping,
surface pitting, sclerotic new bone formation, eburnation and Schmorl’s nodes. Specific vertebral
articulations analyzed were individual zygapophyseal facets, and intervertebral symphyses.
Severity was visually assessed through an ordinal scale of 0 – 3. Individuals were categorized by
age and sex in order to control for these variables. The relationship between spinal health, social
status and sex is explored. Analysis suggests young adults are similar to middle to older adults,
except for a greater severity in the cervical spine in the latter. Males show an overall severity
across the spine, while females have isolated severity in the cervical and lumbar regions.
Commoners possess greater overall SDJD lesion severity compared to higher ranking
individuals.
The current study represents the first formal attempt with an osteological focus to
investigate Late Moche social stratification at San Jose de Moro, Peru.
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ACKNOWLEDGEMENTS
The biggest gratitude must go to Dr. Deborah Merrett, my supervisor, whose guidance has
brought me through the largest challenges of this endeavor. I am also indebted to Dr. Luis Jaime
Castillo-Butters, director of the San Jose de Moro Archaeological Project, who granted me access
to the material in this study and accommodated me in the field. To Elsa Tomasto and Melissa
Lund, Peruvian bioarchaeologists and mentors, whose support and advice during the collection of
this data kept me motivated and excited during my time there. To the rest of the members of the
PASJM team whom are also my dear friends: Solsiré Cusicanqui Marsano, Julio Saldaña, María
Claudia Herrera, Karla Patroni, among many more, thank you for your swift and heartfelt
assistance in logistic and administrative matters. To my many friends scattered across the world,
thank you for the emotional encouragement during my episodes of almost certain despair. And
lastly, to my parents, Wend and Margaret, thank you most of all for your unwavering faith in my
abilities and undying sacrifice to provide me with a better future.
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TABLE OF CONTENTS
ABSTRACT ...................................................................................................................................... i
ACKNOWLEDGEMENTS ............................................................................................................. ii
TABLE OF CONTENTS ................................................................................................................ iii
LIST OF FIGURES ......................................................................................................................... v
LIST OF TABLES ......................................................................................................................... vii
CHAPTER 1: INTRODUCTION ................................................................................................. 1
1.1 Introduction ............................................................................................................................ 1
1.2 Purpose of the Study............................................................................................................... 1
1.3 Thesis Outline ........................................................................................................................ 2
CHAPTER 2: ON THE INTERPRETATION OF SKELETAL LESIONS ............................. 3
2.1 Introduction ............................................................................................................................ 3
2.2 The Osteological Paradox ...................................................................................................... 3
2.3 Responses to the Osteological Paradox .................................................................................. 5
2.4 Osteoarthritis in Light of the Osteological Paradox ............................................................... 7
2.5 Summary ................................................................................................................................ 8
CHAPTER 3: OSTEOARTHRITIS AND JOINT BIOLOGY .................................................. 9
3.1 Introduction ............................................................................................................................ 9
3.2 Synovial Joint Biology ........................................................................................................... 9
3.3 The Aetiology and Pathogenesis of Osteoarthritis ............................................................... 10
3.4 The Progression and Diagnosis of Osteoarthritis ................................................................. 13
3.5 Osteoarthritis and Other Diseases ........................................................................................ 14
3.6 Summary .............................................................................................................................. 15
CHAPTER 4: SPINAL DEGENERATIVE JOINT DISEASE ............................................... 17
4.1 Introduction .......................................................................................................................... 17
4.2 Anatomy of the Spine ........................................................................................................... 17
4.3 Degeneration of the Spine .................................................................................................... 20
4.4 Diagnosing Spinal Degenerative Joint Disease .................................................................... 22
4.5 Limitations to the Study of Spinal Degenerative Joint Disease ........................................... 22
4.6 Summary .............................................................................................................................. 24
CHAPTER 5: THE ARCHAEOLOGICAL CONTEXT OF SAN JOSE DE MORO .......... 25
5.1 Introduction .......................................................................................................................... 25
5.2 Environmental Context......................................................................................................... 26
5.3 Chronology ........................................................................................................................... 26
5.4 Sociopolitical Organization .................................................................................................. 27
5.5 Social Stratification and Burial Contexts ............................................................................. 29
5.6 Moche Collapse .................................................................................................................... 31
5.7 Summary .............................................................................................................................. 32
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CHAPTER 6: MATERIALS AND METHODS ....................................................................... 34
6.1 Materials ............................................................................................................................... 34
6.1.1 Time Period ................................................................................................................... 34
6.2 Methods ................................................................................................................................ 35
6.2.1 Diagnostic Criteria ......................................................................................................... 36
6.2.2 Points of Observation .................................................................................................... 38
6.2.3 Age and Sex Estimation................................................................................................. 38
6.2.4 Social Status................................................................................................................... 38
6.2.5 Preservation ................................................................................................................... 39
6.2.6 Statistical Methods......................................................................................................... 39
CHAPTER 7: RESULTS ............................................................................................................ 40
7.1 Introduction .......................................................................................................................... 40
7.2 Zygapophyseal Facets .......................................................................................................... 40
7.3 Vertebral Bodies ................................................................................................................... 42
7.4 Summary .............................................................................................................................. 44
CHAPTER 8: DISCUSSION ...................................................................................................... 45
8.1 Introduction .......................................................................................................................... 45
8.2 Age ....................................................................................................................................... 46
8.3 Sex ........................................................................................................................................ 47
8.4 Social Status ......................................................................................................................... 50
8.5 Summary .............................................................................................................................. 52
CHAPTER 9: FUTURE DIRECTIONS .................................................................................... 53
REFERENCES CITED ............................................................................................................... 55
APPENDIX I: ZYGAPOPHYSEAL FACET SCORES ........................................................... 65
APPENDIX II: VERTEBRAL BODY SCORES ...................................................................... 67
APPENDIX III: SKELETAL SAMPLE INDIVIDUALS ........................................................ 69
APPENDIX IV: DATA COLLECTION FORM....................................................................... 71
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LIST OF FIGURES
Figure 3.1. Drawing of normal and osteoarthritic knee ................................................................. 10
Figure 4.1. Drawing of typical thoracic vertebra ........................................................................... 18
Figure 4.2. Various ligaments of the thoracic vertebrae ................................................................ 19
Figure 4.3. Uncovertebral joint ...................................................................................................... 19
Figure 4.4. Intervertebral disc fissure ............................................................................................ 20
Figure 5.1. Regional map of Peruvian north coast with Moche sites............................................. 25
Figure 5.2. Drawing of typical thoracic vertebra ........................................................................... 26
Figure 5.3. Moche ceramic sequence and chronology ................................................................... 27
Figure 5.4. Expansion stages in the Jequetepeque Valley ............................................................. 28
Figure 5.5. Moche social pyramid ................................................................................................. 29
Figure 5.6. Drawing of boot tomb in cross-section........................................................................ 30
Figure 5.7. Drawing of Sacrifice Ceremony scene ........................................................................ 31
Figure 6.1. Sample size categoriezed by age, sex and burial type ................................................. 34
Figure 6.2. Map of excavation units at SJM .................................................................................. 35
Figure 6.3. Visual scale of zygapophyseal facet severity .............................................................. 36
Figure 6.4. Visual scale of vertebral body severity ........................................................................ 37
Figure 7.1. Thoracic nueral arch and lumbar vertebral body ......................................................... 40
Figure 7.2. Zygapophyseal facet severity frequencies by age ....................................................... 40
Figure 7.3. Zygapophyseal facet severity frequencies by sex ........................................................ 41
Figure 7.4. Zygapophyseal facet severity frequencies by burial type ............................................ 41
Figure 7.5. Vertebral body severity frequencies by age................................................................. 42
Figure 7.6. Vertebral body severity frequencies by sex ................................................................. 43
Figure 7.7. Vertebral body severity frequencies by burial type ..................................................... 43
Figure 8.1. Ceramicist recreates Moche ceramic vessel ................................................................ 46
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Figure 8.2. Drawing of naked-bound prisoners in procession ....................................................... 48
Figure 8.3. Modern Andean weaving and preserved prehistoric textile ........................................ 49
Figure 8.4. Various Moche ceramic vessels .................................................................................. 50
Figure 8.5. Woman wedging clay on floor .................................................................................... 51
Figure 8.6. Moche headdresses made of gilded copper ................................................................. 51
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LIST OF TABLES
Table 6.1. Operational definition of osteoarthritis ......................................................................... 38
Table 7.1. Chi-square and significance values for zygapophyseal facets and age ......................... 40
Table 7.2. Chi-square and significance values for zygapophyseal facets and sex ......................... 41
Table 7.3. Chi-square and significance values for zygapophyseal facets and burial type ............. 42
Table 7.4. Chi-square and significance values for vertebral bodies and age ................................. 42
Table 7.5. Chi-square and significance values for vertebral bodies and sex ................................. 43
Table 7.6. Chi-square and significance values for vertebral bodies and burial type ...................... 43
Table 7.7. Summary of Chi-square and significance values .......................................................... 44
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CHAPTER 1. INTRODUCTION
1.1 Introduction
This study focuses on prehistoric demographic differentiation at the Moche site of San Jose
de Moro, Peru, as revealed by the severity of spinal degenerative joint disease (SDJD) (also referred
to as osteoarthritis (OA) interchangeably throughout this text). SDJD has been used in similar studies
as a gauge of prehistoric health (e.g. Sandness & Reinhard, 1992; Stirland & Waldron, 1997; Hukuda
et al., 2000; Rojas-Sepulveda et al., 2008). Here it is used as a non-specific measure of the quality of
life an individual had endured. Through comparisons between age classes, sexes and social classes,
this study contributes to the growing body of knowledge regarding Moche social stratification.
The entirety of this thesis can be subdivided into two sections: the first covers the background
research necessary for this type of study (Chapters 2 to 5), and the second details the actual
collection, analysis and interpretation of data, and directions for the future (Chapters 6-9). The
dataset was collected and recorded with the support of the San Jose de Moro Archaeology Project
over the summer field season of 2013. Actual skeletal material originated from several field seasons
as far back as 1995. Despite the rich mortuary resources available from this site, intensive
osteological research has been scarce. This study presents the first attempt at utilizing the San Jose de
Moro skeletal assemblage with a paleopathological focus on spinal degenerative joint disease.
1.2 Statement of the Problem
Social stratification has traditionally been inferred in Moche studies from the unequal
treatment and preparation of graves (Chapdelaine, 2011). This implies that individual members of
Moche society were not treated equally in their everyday lives, and that some form of division of
labour was in place. This implication has not been verified osteologically. If no such stratification
exists, and men and women of all ages equally shared in the maintenance of society, then we can
expect no observable significant differences in the patterns of OA severity other than what is
expected from clinical data (e.g. increasing severity with age). However, if such a stratified system
was in place, then we can expect to see varying patterns of OA lesion severity between age, sex and
social classes.
The purpose of this research is to explore the possibility of using spinal osteoarthritis severity
as a proxy and relative measure for the differences in the quality of life the Moche people endured.
This is accomplished through the examination of 67 individual vertebral columns from the skeletal
population at San Jose de Moro, a Moche cemetery site in the Jequetepeque Valley. By analyzing
spines from different demographic sectors of this population (age, sex and social class), the
hypothesis that differential OA severity occurs in this population due to social stratification is tested.
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1.3 Thesis Outline
In Chapter 2, the theoretical backdrop for the analysis and interpretation of human skeletal
remains is discussed, drawing mainly from the work of Wood, Milner, Harpending and Weiss
(1992). The Osteological Paradox questions the plausibility of health interpretations from skeletal
lesions and age-at-death distributions (Wood et al., 1992). Specifically, osteoarthritis is evaluated in
light of the issues put forth by Wood and colleagues (1992).
In order to properly interpret the disease in archaeological settings, an in-depth review of
human joint biology and osteoarthritis is considered with respect to both clinical and anthropological
literature in Chapter 3. OA aetiology, progression, and diagnosis are covered, as well as some
limitations to archaeological studies involving OA.
Because this research focuses on the degeneration of the vertebral column, SDJD is
highlighted in Chapter 4 through an examination of spinal joint anatomy and functionality. The
degeneration of the spine is elaborated, and its differential diagnosis is discussed with respect to the
limitations of such a study. OA (SDJD) is then given utility as a measure of quality of life of the
Moche people.
Chapter 5 strengthens the preceding chapter through an overview of Moche archaeology with
a focus on the archaeological context of San Jose de Moro in the Jequetepeque Valley. The cultural
entity known as the Moche, or Mochica, is described primarily concerning the archaeological and
iconographic evidence. Emphasis is given to sociopolitical organization and funerary practice, as
these are essential in associating burial context to specific demographic sectors of the community.
Chapter 6 concerns the actual materials that comprise the data set of this analysis. This is
comprised of 67 skeletons that were excavated at San Jose de Moro during the summer field seasons
from 1995 to 2013. The methodological approach is also provided, which outlines the various steps
and decisions that were taken through the course of data collection.
Following a description of these materials and methods, Chapter 7 provides the results and
analyses.
In Chapter 8, a discussion and interpretation of the results is given. These are built around a
dual framework that combines the paleopathological evidence with the available archaeological
record. This is also where several conclusions are made about the significance and meaning of the
data.
Chapter 9 brings to light several issues that were encountered throughout the research
process, and how these may be remedied in the future.
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CHAPTER 2. ON THE INTERPRETATION OF SKELETAL LESIONS
2.1 Introduction
The discipline of paleopathology has grown beyond single case descriptions of skeletal
lesions to a more population-scale analysis of diseases in past human cultures (Wood et al., 1992;
Larsen, 2002; Wright & Yoder, 2003). Because the human skeleton can retain physical memories of
past events and provide a wealth of information on the lifeways of people, it serves as the prime
evidence for archaeologists looking to understand the past. In this respect, bioarchaeologists and
paleopathologists are responsible for analyzing skeletal deviations from the norm, and linking these
observations to workable interpretations. Lesions on the human skeleton have been used to infer
physical activities and behaviour (e.g. Bridges, 1992; Molleson, 2007), disease, nutrition, and health
(e.g. Suby & Guichon, 2009; Liebe-Harkort, 2010; Novak et al., 2012), diet and subsistence (e.g.
Corruccini1983; Mays & Beavan, 2012), violence and traumatic events (e.g. Verano, 2001; Lessa,
2004), and much more (see Larsen, 2002, for a representative overview). Thus, bioarchaeology and
paleopathology can be indispensable and powerful tools in furthering our understanding of the
human condition. However, as with every tool, there are dangers to its use. Our interpretations must
be grounded in evidence, especially in archaeology when we are dealing with the unknown past
(Hodder & Hutson, 2003).
In recent decades, the intuitive approach to understanding past health from skeletal samples
has been questioned (i.e. Wood et al., 1992), as well as the methods by which the assemblages under
study are measured (i.e. Bocquet-Appel & Masset, 1982). Specifically, Wood et al.’s (1992) call to a
reevaluation of traditional views sparked a flurry of subsequent papers debating the future of
paleopathology. Their paper eloquently synthesized the various problems that had already been
circulating throughout the paleopathological community (e.g. Buikstra & Konigsberg, 1985; Ortner,
1985, pers. comm., cited in Eisenberg, 1992; Jackes, 1992), namely issues with selective mortality
and hidden heterogeneity in risks (Wood et al., 1992). What has been termed the “Osteological
Paradox” by James Wood and colleagues (1992) can be defined as a suite of interpretations that
disputes the representativeness of skeletal assemblages as reflections of health in a once-living
population. Others have argued that the validity of such paradoxes is misplaced and viewed out of
context (Goodman, 1993; Cohen, 1994). Both factions, however, agree that an in-depth
understanding of the pathogenesis of the disease under question can greatly illuminate the debate.
Here, the manifestation of osteoarthritis and its viability as an indicator of past human health are
considered in terms of the three main issues of the Osteological Paradox.
2.2 The Osteological Paradox
Conventional and instinctive approaches suggest a direct relationship between measures of
past health and an individual’s risk of death or disease (critiqued in Buikstra & Konigsberg, 1985;
Horowitz et al., 1988; Milner et al., 1989; Wood et al., 1992, Goodman, 1993; Cohen, 1994). For
instance, skeletons with more lesions are likely interpreted as sicker or frailer, while those with few
to no lesions would be described as healthier members of the group. However, a paradox may arise
in antithetic scenarios. As Wood and colleagues (1992: 343) put it, “most interpretations of
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paleodemographic and paleopathological data presuppose that such straightforward relationships
exist.” The underlying basis for a paradox is that inferences about the living are being made from the
dead. The authors raise three important conceptual problems brought about by the expansion of
paleopathology and paleodemography as disciplines of active research – demographic
nonstationarity, selective mortality, and hidden heterogeneity in risks (Wood et al., 1992).
Demographic nonstationarity refers to the nature of populations to deviate from fixed states.
Populations are never completely isolated from migration, or immune to changes in growth rates. In
reality, populations fluctuate frequently and constantly in fertility and mortality rates, and age and
sex distributions. When observing age-at-death distributions, the skeletal ages of dead individuals are
observed. A temptation to infer mortality curves from this data may result. On the contrary, it has
been shown that changes in the fertility of a population strongly affect the age-at-death distribution
(Wood et al., 1992; Jackes, 1993). Thus, age-at-death statistics represent fertility measures rather
than mortality measures (Wood et al., 1992). Although this problem has key importance in
paleodemography, and is dealt with by Mary Jackes (1992) and others, it is not widely expounded on
in Wood et al.’s (1992) paper. Rather, they focus on selective mortality and hidden heterogeneity in
risks, as these are even more pertinent to understanding the representation of a disease in a cemetery
population.
Selective mortality states that the sample is only indicative of those who suffered and died at
that age, but not of all individuals at that age. It only selects for the risks represented in those that
died of that age group and not the distribution of risks experienced by all individuals involved in that
age group. The population at risk cannot be determined from a skeletal sample. A sample does not
represent the risk of death for those individuals who had lived past the age in question. Consequently,
any skeletal sample can be considered unrepresentative of the once-living population at risk of death
(Wood et al., 1992). Selectivity biases may overestimate condition prevalence by providing an
observer with only those individuals that had actually died at that age, while low sensitivity to
actually develop skeletal lesions from chronic illnesses may underestimate condition prevalence
(Wood et al., 1992). This interplay between overestimation and underestimation may never be
resolved because of the obvious lack of data from the living population.
Hidden heterogeneity in risks refers to the unknown differences among individuals in a
population in their susceptibility (i.e. frailty) to death. These could be due to differences in genetics,
socioeconomic status, microenvironmental exposure, temporal health trends, or any variation of these
(Wood et al., 1992). The nature of archaeological research does not make us privy to the level of risk
exposure experienced by an individual in the past, at least not to the level of accuracy we would
require for analysis of living populations. It is also very difficult to establish significant relationships
between aggregate-level estimations of health and affected individuals when such heterogeneity
exists. As such, several subgroups presenting different levels of risk may exist, but remain
undetected when observed through skeletal assemblages. Furthermore, the likelihood of developing
a skeletal lesion from a disease muddles the investigation. A high prevalence of lesions could
intuitively be read as a sign of increased disease, but could paradoxically be interpreted as a sign of
better health. Often, the skeleton is the last region of the body to be attacked by a disease, and even
then, only a portion of people will manifest an observable bony response. The presence of advanced
lesions could paradoxically indicate survival, or at least increased resistance, against a disease
because the individual lived long enough through it to mount a bony response. Bioarchaeologists are
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also primarily concerned with the skeletal markers of stress and its relationship to activity and health.
The paradox questions whether higher scores for stress markers reflect increased stress experienced
by an individual, or an increased ability to endure stress (Jackes, 1993). Furthermore, inherent in
these observations is the assumption that the lesions observed are directly connected to cause of
death. This is not often the case. The paradoxes just described can very likely be the root of
misinterpretation of osteological evidence (Wood et al., 1992). It is here that knowledge of both the
biology of a disease and the archaeological context in which the remains are found become essential.
2.3 Responses to the Osteological Paradox
Based on the initial comments (e.g. Katzenberg, 1992; McGrath, 1992; Roth, 1992), Wood et
al.’s (1992) criticism was well received. Scholars believed that the problems raised were significant
and a step forward. However, the subsequent years following its publication in 1992 produced
several responses. A notable contender was Mark Nathan Cohen, who argued that cemetery
collections were, at least on average, representative of the once-living populations (Cohen, 1994). He
asserted that this assumption was valid and allowed paleopathologists to link changes observed
among the dead as reflections of real changes that had once occurred among the living. In particular,
his reply is targeted towards Wood and colleagues’ (1992) interpretation of improved health
following the global shift to agriculture, contrary to the interpretation of Cohen and Armelagos
(1984). Wood et al. (1992) reason that agriculture fostered better nourished, healthier individuals,
more able to survive and thus develop skeletal lesions in times of disease, versus relatively lesionfree hunter-gatherers and foragers. Cohen (1994) argues that several lines of evidence support his
and Armelagos’s interpretation. Ethnographic and contemporary epidemiological data would suggest
an increase in disease prevalence with increased population sizes and sedentism. Moreover, optimal
foraging theory advocates hunter-gatherers were at a better nutritional advantage. Cohen (1994) also
turns to the higher incidence of dental caries in farmers, and arthritis in hunter-gatherers. He retorts
whether hunter-gatherers had died from carious infections “before their teeth had had the chance to
develop lesions while farmers lived long enough to develop caries,” or whether hunter-gatherers
lived long enough to allow arthritic lesions the chance to form versus their farming counterparts that
died before arthritis could manifest (Cohen, 1994: 631). A sample can also be considered
representative since not all deaths are caused by the pathology in question or only by that pathology
alone. The random component involved in selecting those who die creates a reasonably
representative sample (Cohen 1994). This is a surprising statement, and may be further refined to
include both stochastic and deterministic components to mortality. The existence of pooled risk
groups demonstrates that nonstochastic mortality still plays a major role in shaping life tables (Wood
& Milner, 1994). Additionally, the representativeness of a certain handful of diseased individuals of
the health status of an entire population is questionable.
Another key response to the Osteological Paradox is Alan Goodman’s (1993) critique, stating
that Wood et al.’s (1992) paradox exists only because of their narrowed focus of one, instead of
multiple indicators of health. The Paradox oversimplification forgets to consider that most indicators
(e.g. activity-induced lesions, enamel hypoplasias, porotic hyperostosis) imply survival of the
individual after the morbidity event (Goodman, 1993). According to Goodman (1993), examination
of multiple gauges of health is the key to weeding out paradoxical interpretations. Wood et al. (1992)
seem preoccupied with causes of death, when in fact the goals of paleoepidemiology are to measure
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the effects of disease, even ones with no real mortality threat, on a population (e.g. affected
workloads, reproduction, and cultural and social changes) (Goodman 1993). Furthermore, Wood et
al.’s (1992) analysis fails to include the important role of cultural practices in reconstructing past
events. Apart from the move of paleopathology to more population-based research, the discipline has
also advanced by using a multi-indicator approach in detecting prehistoric health. Consequently,
researchers cannot become complacent with investigating only a single indicator, but must expand
their scope either by further personal work or by the inclusion of parallel works of others. Models
have also been put forth to contextualize these health and stress indicators (Goodman, 1993; Wright
& Yoder, 2003), and the study of human remains has grown to include multiple fields of study to
enhance our understanding of the cultural contexts and biological processes that lead to lesion
development (Wright & Yoder, 2003).
A decade after Wood et al.’s publication, Wright and Yoder (2003) sought to bring the
bioarchaeological community back to the issues raised and update its significance. Studies are
limited by the samples found, and consequently limit population-based studies as well. Our analyses
of the past are then dependent on the representativeness of skeletal samples and our discerning
interpretations of multiple alternative hypotheses. Wright and Yoder (2003) review five areas where
bioarchaeology has grown to fill the holes that make up the paradox. These are demography,
biodistance, paleodiet, growth disruption, and paleopathology. The progress described here is the
continual refinement of age and sex estimation techniques (Meindl & Russell, 1998; Jackes, 2000),
and development of ancient DNA and stable isotopic technologies to help demographic, biodistance
and paleodiet issues. The field of enamel growth has also been extensively expanded, and has been
used reliably to study biodistance, paleodiet and growth disruptions. They suggest that histological
analysis may be especially significant in addressing the paradox because it may present the amount
of healing (or lack thereof) occurring at a cellular level at the time of death (Wright & Yoder, 2003).
Nevertheless, macroscopic evaluation will continue to be at the forefront of paleopathology since
histology and ancient DNA can be costly and destructive. The authors suggest continued focus on
refining the differential diagnosis process and study of varying pathognomonic lesions in order to
better understand susceptibility to infection and death (Wright & Yoder, 2003).
These discussions do not even begin to consider other factors outside of disease that may bias
the representativeness of a sample. These include methodologies in excavation, recovery and
analysis, and survival biases of skeletons (Gordon & Buikstra, 1981Walker et al., 1988; Saunders &
Hoppa, 1993; Pinhasi & Bourbou, 2008). Physical, chemical and biological agents are all at play.
Differences in soil conditions (Gordon & Buikstra, 1981) and weather in separate regions can
produce contemporaneous samples that have drastically different preservation quality. Even different
bony elements within one skeleton are differentially affected by preservation. Fetal and infant
remains are also disadvantaged in making it to analysis (Pinhasi & Bourbou, 2008).
Paleopathologists must be privy to these issues, as missing or damaged skeletal elements with
pathological lesions will skew the data. Paleodemographers should also be aware of the
underrepresentation of subadult remains. Although infant skeletons are often better preserved than
their adult counterparts in some contexts (Walker et al., 1988; Merrett, pers. comm., 2013; see
Pinhasi & Bourbou, 2008 for opposing view), cultural issues may still bias the sample. It could be
that burial of subadults was dictated by social norms, and subadults were buried separate from the
adult cemetery. It has been shown that cemeteries often segregated burials according to age, sex, and
status, for example (Andrews & Bello, 2006; Bello & Andrews, 2006). Pseudopathology, also at the
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core of observer error, refers to the interpretation of post-mortem changes as ante-mortem
pathological conditions. Just as significant are the misdiagnoses of pathological lesions. These are
potential sources of error that can distort results. Pinhasi and Bourbou (2008) suggest these issues be
evaluated by researchers on a “case-to-case basis” owing to the huge variation in mortuary
conditions. In addition, clearly illustrated methodologies and diagnostic criteria must be established
before the investigation even commences. This may include gathering knowledge of a site’s
geochemical properties, climatic history, possible bioturbative agents, and previous conclusions of
specific mortuary peculiarities of the culture in question. Biases and pitfalls insert themselves into
every step of the research process. These biases can be grouped into two categories: 1) those
uncontrolled by the observer (prehistoric cultural practices and bone survival), and 2) those
controlled by the observer (search, recovery and analysis methodology) (Pinhasi & Bourbou, 2008).
Investigators should be aware of these potential traps for incorrect evaluations. Such an attention to
detail will describe the future course of paleopathology and paleoepidemiology, and illuminate
understanding of morbidity profiles of the past.
2.4 Osteoarthritis in Light of the Osteological Paradox
It is apparent that each pathology is unique in its nature, and must first be evaluated
separately from the manifestations of other diseases, even when co-occurring in the same body. In
reality, health is so broad a dimension that reliance on the most convenient indicator cannot be
thought of as representative (Wright & Yoder, 2003). I propose that not all diseases suffer at the
hands of ambiguous interpretations challenged by the Osteological Paradox, but other factors
creating the mortality profile of a sample causes enough interference that even thorough investigation
of one line of evidence is insufficient in the absence of other corroborating avenues. This thesis
explores just one of these avenues, looking at osteoarthritis as a potential indicator of the quality of
life a person had endured. It is my hope that other researchers explore questions about class structure
in Moche daily life at San Jose de Moro, and whether such findings will corroborate or refute the
observations and interpretations here. Osteoarthritis is not a perfect indicator of the quality of life.
Although the severity of OA lesions may progress, increasing joint stress, pain, discomfort and
disability may never manifest or correlate in the living individual (Birrell et al., 2005; Busija et al.,
2006). Furthermore, the formation of lesions does not progress uniformly in every individual due to
genetic predispositions (Rogers et al., 1997). Such factors are nearly impossible to discern in the
archaeological record. These obstacles are further discussed in Chapter 3.
Osteoarthritis has been used classically as an indicator of health and stress (e.g. Merbs, 1983;
Bridges, 1992, 1994; Stirland & Waldron, 1997; Rojas-Sepulveda et al., 2008; Molnar et al., 2011;
Novak et al., 2012). The rationale behind the use of chronic afflictions, such as arthritis, is its
progression in a relatively straightforward manner (Cohen, 1994). What Wood et al. (1992) had been
describing in their paper were diseases that progress through other body systems before finally
affecting the skeletal system, assuming the individual survived long enough and if bony lesions
developed at all. Osteoarthritis, among several other osteological diseases, can be considered a
primary disease of the skeletal system, as it originates from the inevitable wear and tear of synovial
joints and can directly change the morphology of bone (Brandt et al., 2006). The presence of this
degenerative disease is not a major factor in deaths making its prevalence in a skeletal assemblage a
relatively reliable reflection of the prevalence in the once-living population (Waldron, 1994: 101).
7
However, although it is accumulated throughout life, the levels of arthritic lesions present on a
skeleton influence not only with the amount of physical stress exerted on the joints, but also are
caused by sex, age and genetics. Moreover, the study of “bone formers” by Rogers and colleagues
(1997) present a different view by identifying certain members of the population predisposed to
growing bony lesion even in the absence of environmental stressors. Intentions of measuring the
relative quality of life in a skeletal sample through the evaluation of osteoarthritic severity is not
without its faults, but an attempt is still made here to open the possibility of future research from a
refinement of the techniques used here as well as other investigative tools.
2.5 Summary
The interpretation of skeletal lesions remains a challenging prospect. On the one hand,
intuitive approaches have had success in the past (Rojas-Sepulveda et al., 2008). On the other hand,
paradoxical situations may hold some validity. If one thing can be learned from this back-and-forth
debate, it is that interpretations must be tailored to the sample at hand, keeping in mind the cultural
context and the indicators of health in question. The biology of a disease, the mortuary activities of
past peoples, and the taphonomic processes at play are all instrumental in solidifying the
representativeness of skeletal assemblages.
Although spinal degenerative joint disease remains the focus of this research, the proposals of
Goodman’s (1993) and Wright and Yoder’s (2003) multi-indicator approach remain critical in
dealing with the Osteological Paradox and building inferences of past health. With regards to
osteoarthritis, it seems degenerative joint disease serves as only one indicator of stress. Nonetheless,
progressively worsening lesions may not impact the living person, or his or her ability to contribute
to their community (Birrell et al., 2005; Busija et al., 2006), or even reflect a mechanical response
(Rogers et al., 1997). Consequently, a review of joint biology and osteoarthritis is necessary to bring
to light the shortcomings and important considerations of this type of study.
8
CHAPTER 3. OSTEOARTHRITIS AND JOINT BIOLOGY
3.1 Introduction
Motion in vertebrates is facilitated by the antagonistic push and pull of musculature exerted
on the skeletal system. The skeleton, with its many constituent elements, provides a foothold for
these muscles. In humans, the different bones of the body are articulated to one another via joints,
with the exception of the hyoid or floating bone. There are many types of joints in the human body,
the most common of which are synovial joints (Waldron, 2009). Different types of joints serve
different functions, and the changes we observe can illuminate the biological profile of an individual.
Some joints change morphology with age, and this has been used by physical anthropologists to age
skeletons (e.g. changes to the auricular surface, pubic symphysis, sternal rib ends, cranial sutures, see
Buikstra & Ubelaker, 1994). The degenerative changes to joints can also be accelerated by physical
stressors, and have been used to infer activity and occupation (e.g. Bridges, 1992; Stirland &
Waldron, 1997; Molleson, 2007; Molnar et al., 2011).
The inevitable wear and tear of joints from regular use characterizes osteoarthritis (OA), also
known as degenerative joint disease (DJD) (Creamer & Hochberg, 1997; White & Folkens, 2005;
Waldron, 2009; Anderson & Loeser, 2010). Osteoarthritis can be described as the gradual breakdown
of articular cartilage within synovial joints (Goldring & Goldring, 2007). The cartilage serves as a
cushion between two bones, and when this cushion is compromised, the bones begin to grind away at
each other eliciting various changes to the joint. It is the most common skeletal disease encountered
worldwide by archaeologists and paleopathologists (excluding dental diseases) (Creamer &
Hochberg, 1997; Weiss, 2006; Weiss & Jurmain, 2007; Molnar et al., 2011; Lotz & Loeser, 2012).
Its diagnosis in skeletal samples has been used to infer handedness, and the differences between
sexes, social status and populations (Bridges, 1992). Our knowledge of OA is far from complete.
There is still a lot of debate surrounding OA aetiology and diagnosis, especially between
anthropologists and clinicians. This section tackles the essential aspects of synovial joint biology,
followed by a discussion on OA aetiology and pathogenesis, progression and diagnosis, and its
relation to other diseases.
3.2 Synovial Joint Biology
A joint is where any two or more bones meet (Waldron, 2009). Different types of joints vary
in their mobility, and serve different functions as a result. Sutures are immobile fibrous connections
that hold bones of the skull in place. Syndesmoses are fibrous joints with minor movement only
permitted by the slight stretching of ligaments that hold them in place. A gomphosis fixes dentition
to its respective alveolus in the oral cavity. Symphyses join bones through a fibrocartilaginous tissue.
The degree of movement in a symphysis, such as the pubic symphysis or intervertebral discs, is very
limited. Synchondroses are those joints temporarily formed from the hyaline cartilage model of
developing bone in subadults. Synovial joints are those that contain a synovial membrane and are
fully mobile. They are the most common joints in the human body, and are most commonly affected
by disease (Waldron, 2009). Two joints constitute the articulations of the vertebral column, namely
the symphyses between the intervertebral discs and vertebral bodies and the synovial joints between
9
zygapophyseal facets, uncovertebral joints and costovertebral joints (see section on Spinal
Degenerative Joint Disease).
The synovial joint can be considered as an organ because of the diverse tissue types that
compose it, and as such, pathologies affecting one tissue type will have subsequent effects on
adjacent parts (Archer et al., 2003). A synovial joint is composed of the bones involved, each coated
by hyaline articular cartilage and held together by ligaments, synovium, and fibrous capsules (Archer
et al., 2003). The synovial membrane exists to nourish chondrocytes, lubricate joint surfaces, and
clean the joint of any debris or microorganisms resulting from the degeneration of the joint
(Waldron, 2009). The cartilage that coats the articulating surfaces of bone is avascular and aneural,
which results in a low capacity for self-repair and high susceptibility to degenerative diseases such as
OA (Oldershaw, 2012). Healthy articular cartilage is very efficient in reducing the friction between
bones during movement (Waldron, 2009). It does not show up on radiographs, but appears as a void
space between bones, referred to by radiologists as the joint space. Directly curved beneath the
cartilage is subchondral bone, usually composed of trabeculae that is covered by a thin cortex
without periosteum. Synovial joints are instrumentally significant to the study of OA because OA
only develops at joints that move (Waldron, 2009).
3.3 The Aetiology and Pathogenesis of Osteoarthritis
Anthropologists, skeletal
biologists and medical doctors
unanimously agree that the cause of
osteoarthritis is multifactorial,
encompassing a number of
precipitants and guilty agents (Busija
et al., 2010; Hunter, 2011). It should
be understood that no one risk factor
can solely contribute to the
development of OA, but a
combination of these are responsible.
Some risk factors such as age and
obesity carry greater weight as
precipitants (Anderson & Loeser,
2010; Loeser, 2011). Although OA is
conventionally defined as the
destruction of the articular cartilage
resulting in joint failure, it is not a
disease that manifests exclusively in
cartilage (Brandt et al., 2006). Rather,
Figure 3.1. Schematic drawing of the knee joint juxtaposing the components
of a normal knee (left) and joint tissues affected in OA (right). Modified
it seems many of the tissues involved
from Hunter, 2011: 802.
in the diarthrodial organ can be
attributed to the aetiology of the
disease, whether it be the subchondral bone, synovium, capsule, periarticular muscles, sensory nerve
endings, meniscus (if present), or ligaments (Brandt et al., 2006) (Fig. 3.1). Ultimately, the disease
10
occurs when the equilibrium of breakdown and repair of joint tissues becomes unbalanced (Hunter,
2011). Such a situation can be elicited in two ways: 1) by intrinsic factors and by 2) extrinsic factors.
Intrinsic factors are inherent to the body such as age, body mass, sex and genetic predisposition.
Extrinsic factors are those forces outside the body acting on its joints. These are the mechanical loads
produced from occupation and activity or traumatic events. OA is often referred to as primary when
no direct cause can be attributed to its formation, but arises from the multifactorial nature of its
aetiology (Creamer & Hochberg, 1997, Waldron, 2009). Not one single precipitant can be positively
assigned as the proximate cause. The term secondary OA is used when a single cause can be
identified such as OA following trauma or rheumatoid arthritis (Waldron, 2009). OA is a
mechanically induced disease, whether initially resulting from excessive loads on normal tissues,
normal loads on abnormal tissues, or a combination of the two (Brandt et al., 2006). The
pathogenesis of OA can be attributed to highly varied interactions of mechanical, cellular and
biochemical agents (Hunter, 2011).
Age has long been accepted as a major factor in osteoarthritis development. In general, older
individuals exhibit more widely dispersed, severe cases of OA than younger individuals. This would
make sense since the longer a joint is in use, the more the joint will deteriorate. On the other hand,
OA is ordinarily described as joint wear and tear, but OA is not simply the result of the waning uselife of a joint, but rather the disruption of healthy cellular and biochemical functions (Lotz & Loeser,
2012). Aging cartilage is not necessarily cartilage inflicted with OA (Goldring & Goldring, 2007).
Several researchers agree that increasing chondrocyte senescence contributes to the development of
OA (Anderson & Loeser, 2010; Loeser, 2011; Lotz & Loeser, 2012). The disruption of normal
chondrocyte abilities to maintain cartilage produces increased cytokines, oxidative damage and
decreased growth factors, which all stimulate cellular death (apoptosis) and matrix degradation
(Goldring & Goldring, 2007; Anderson & Loeser, 2010).
The turnover from muscle mass to fat mass that accompanies age has also been suggested as
an explanation for OA in older individuals due to increased joint loading (Loeser, 2011). Obesity in
modern times is the “single most important risk factor for development of severe OA of the knee”
(Hunter, 2011: 804). The knee joint is particularly sensitive to obesity (Manek et al., 2003; Hunter et
al., 2005; Hunter, 2011), but hardly affects the hip (Creamer & Hochberg, 1997), which might
suggest mechanical factors are not OA’s sole contributor, but rather other factors are also important
(Creamer & Hochberg, 1997). In archaeological settings, it is doubtful individuals were overweight
to the same degrees observed today due to a lack of foods with high fat and sugar contents (Arriaza,
1993). The implication of obesity as a major risk factor in archaeological remains is slim. However,
some scholars have attempted to equate the prevalence of diffuse idiopathic skeletal hyperostosis
(DISH) to obesity and insulin-independent diabetes mellitus (Rogers & Waldron, 2001; Mays, 2006;
Verlaan, et al., 2007). These studies have focused on samples from medieval monastic Europe when
fatty foods were more abundant (Mays, 2006) than in preceding periods. The clinical data does
affirm that chronic, heavy loads on joints are an important precipitant for OA (Weiss, 2006; Brown et
al., 2008).
Sex is also a predisposing risk factor, with women being generally more susceptible than men
(Creamer & Hochberg, 1997; Goldring & Goldring, 2007; Hunter, 2011) with up to 50% greater
likelihood of OA development (Busija et al., 2010). It has been suggested that the depletion of
estrogen levels after menopause in women could explain the disparity between the sexes (Busija et
11
al., 2010), although the preliminary reviews are weak (Hanna et al., 2004). Anatomical differences
may also be responsible. Hunter et al. (2005) demonstrated that women, on average, have higher
knee height, which contributes to greater torque when in motion. The greater mechanical forces
involved were associated with increased OA likelihood (Hunter et al., 2005). In contrast to
epidemiological findings, there is a surprisingly broad variation in the manifestation of OA between
males and females from archaeological contexts (Bridges, 1992). Some sites have reported greater
levels of OA in males (Bridges, 1992), greater levels in females (Molnar et al., 2011), or no
significant difference between the two (Waldron, 1995). Sex differences have been used by
bioarchaeologists to infer gender roles in past societies (Molleson, 1994, 2007). The use of only one
indicator to infer activity may be inadequate, but a plethora of indicators may still be useful if a
significant pattern arises that is well documented, comparisons are drawn with other possible
conditions, juxtapositions are made with an equivalent normal sample, and independent
environmental or comparative evidence is reviewed (Wright & Yoder, 2003; Molleson, 2007).
Probably one of the most difficult risk factors to control for in studies of osteoarthritis,
whether in clinical or archaeological settings, is genetic predisposition. Anthropologists are usually
interested with the effects of repetitive mechanical loading and aging on joints. However, clinical
data on twin and familial studies suggest a strong genetic component, influencing OA at an estimate
of 35% to 65% (Cicuttini & Spector, 1997; Fernandez-Moreno et al., 2008). Several investigations
have confirmed that the genetic mechanisms involved in OA follow polygenic inheritance rather than
simple Mendelian pathways (Fernandez-Moreno et al., 2008; Loughlin, 2011). It would seem that
different joints have varying degrees of genetic susceptibility (Spector & MacGregor, 2004; Weiss &
Jurmain, 2007). The hip and spine in particular have the highest heritability estimates at 60% and
70% respectively, while the hand and knee are at 39% to 65% (Spector & MacGregor, 2004). It is
worth noting that genes may not determine the presence or absence of osteoarthritis, but affect the
severity of already present OA (Weiss & Jurmain, 2007). Weiss and Jurmain (2007) urge that spinal
degenerative disease is highly probably not a good indicator of activity because of its heavy reliance
on the genetic component of OA. Furthermore, Rogers et al. (1997) have identified that a portion of
individuals are predisposed to produce more bone than usual, termed so called bone formers. These
bone formers, for example, would produce larger osteophytes versus the average person even when
exposed to similar environments. The larger osteophytes would then be recorded by the
paleopathologist as more severe, and potentially skew the analysis. An attempt to distinguish bone
formers in skeletal assemblages failed to produce any significant results (Schmitt et al., 2007). This
is not to say anthropological studies of osteoarthritis on skeletal remains are hopeless endeavors. In
instances of extreme physical stress, mechanical factors may overwhelm genetic predisposition as
principle aetiological agents (Manek et al., 2003; Thelin et al., 2004). Preliminary data also indicates
that bone formers comprise only a small portion of the population (Rogers et al., 1997). Some of the
limitations of comparative studies caused by genetic components may be reduced by limiting the
sample under study to one geographical origin and incorporating a large enough sample size.
Apart from the factors intrinsic to the biological makeup of the body (age, BMI, sex and
genetics), physical activities influence the development of OA (Creamer & Hochberg, 1997; Hunter,
2011). Waldron (2009: 28) states, “movement is a sine qua non for the production of OA; joints that
do not move, do not develop OA.” This is of prime concern to anthropologists seeking to link stress
and activity to physical markers left on the bone. Molleson (2007) has attempted to create a process
for the differential diagnosis of specific activities. This is a bold attempt, as many scholars caution
12
that specific activities may never be inferred because very different activities can produce similar
lesions, while the same activity can manifest differently between individuals (Gualdi-Russo &
Galletti, 2004; Meyer et al. 2011). Even Molleson (2007) acknowledges the limitations of estimating
activity and occupation but believes a high degree of likelihood is attainable. Certainly, this has not
stopped anthropologists from inferring past occupations (e.g. Bridges, 1994; Molleson, 1994;
Stirland & Waldron, 1997; Molnar et al., 2011). The premise is actually quite valid if conclusions are
made in broad terms. I have no doubt physical stress plays a vital role in OA aetiology, and its
contributions to the development of prehistoric OA cannot be ignored. Perhaps it would be more
prudent to equate higher levels of observed OA to more exposure to physical stress rather than
attempting to assign specific activities.
It should be pointed out that there is a poor correlation between radiographic OA severity and
symptomatic disability (Birrell et al., 2005; Busija et al., 2006). Thus, greater degrees of severity
observed on dry bone may not directly translate to a more impaired lifestyle. However, more severe
manifestations of OA lesions may still indicate more prolonged and greater exposure to mechanical
stress, controlling for age, sex and possibly genetics.
3.4 The Progression and Diagnosis of Osteoarthritis
Several morphological changes occur to the articulating bones as osteoarthritis progresses.
These are what paleopathologists observe and score in postmortem remains. Following Wolff’s Law,
bone will adapt to the mechanical loads acting on it in order to compensate the stress. In joints
afflicted with OA, new bone will begin to form at the joint margins. These are what are referred to as
marginal osteophytes and are observable on radiographs. It has been suggested that their
development expands the articular surface as a way of compensating for the failing joint (Van der
Kraan & Van den Berg, 2007). New bone will also form on the subchondral bone because of joint
surface vascularisation (Rothschild, 1997; Waldron, 2009). These are observable on x-rays as areas
of sclerotic subchondral bone (Creamer & Hochberg, 1997).
The joint surface may in turn exhibit porous lesions that may or may not extend directly into
the underlying trabeculae and unite with subchondral cysts. Rothschild’s (1997) review of clinical
literature has questioned the significance of porosity in diagnosing OA, asserting that porosity’s
clinical significance can only be assumed, as it is not readily observable during life, unrecognizable
on x-ray, and does not appear in standard medical literature. Because it is unseen in radiographs, it is
often excluded from a clinician’s differential diagnosis. The physical anthropologist, however, is
privy to the macroscopic observation of pitted joint surfaces on dry bone. Porosity has been used
diligently by paleopathologists as an indicator of osteoarthritis (e.g. Bridges, 1992, 1993; Buikstra &
Ubelaker, 1994; Weiss & Jurmain, 2007). It is difficult to digest Rothschild’s (1997) contention
when porosity and eburnation are so often encountered simultaneously in both archaeological and
contemporary skeletal material. Its absence in the medical literature may be due to the nature of the
specimens clinicians and anthropologists analyze, and the techniques by which they are analyzed.
Canines subjected to anterior cruciate ligament transections developed OA, and demonstrated
osteopenic subchondral trabeculae (Dedrick et al., 1997). In mice injected with collagenase to induce
instability-related OA, pitting and thinning of the subchondral bone plate resulted from increased
osteoclastic resorption directly beneath the subchondral bone plate (Botter et al., 2011). It should be
13
noted that four weeks after the experiment, the perforations disappeared due to increased osteoblastic
activity in the subchondral bone trabeculae (Botter et al., 2011). Nevertheless, these preliminary
animal models may provide insight into the aetiology of joint surface porosity in osteoarthritis.
Eventually, the joint contour will progress to a flatter and wider appearance than what is
normal. If allowed to develop into its advanced stages, eburnation will follow. Eburnation is the
result of bare bone rubbing on bare bone, and represents the ultimate destruction of cartilage,
creating polished areas on the joint surface. Many researchers consider it pathognominic of OA
(Rothschild, 1997; Weiss & Jurmain, 2007), and some have used it as the sole criterion for
diagnosing OA in the skeleton, fearing the ambiguity of other indicators (e.g. Rojas-Sepulveda,
2008; Molnar et al., 2011). This is faulty however, since eburnated bone illustrates OA in its most
advanced stages (Rothschild, 1997). Thus, limiting a study to only eburnation will undoubtedly miss
those bony elements or whole individuals afflicted with early and intermediate stages of the disease.
The diagnosis of osteoarthritis between clinicians in the living and paleopathologists in the
dead varies considerably. This is in obvious part due to the differences in the viewing methods of
suspected joints. In a live patient, diagnosis is often conducted through palpation. If a joint is affected
by OA, it will be swollen and enlarged. Pain and crackling sensations may also accompany the joint
(Creamer & Hochberg, 1997). Radiologists refer to joint space narrowing, marginal osteophytosis
and sclerotic subchondral regions for a diagnosis (Creamer & Hochberg, 1997; Rothschild, 1997;
Spector & MacGregor, 2004). The paleopathologist on the other hand can add to this list by
including pitting on the joint surface and alteration of the joint contour. Pitting and contour are much
better observed through gross inspection of the bone rather than radiographs or palpation. From this
information, I will adopt Waldron’s (2009) operational definition of osteoarthritis. A joint can be
highly suspect of exhibiting osteoarthritis if eburnation is present, or if at least two of the following
are present: marginal osteophytosis, new bone on the joint surface, pitting on the joint surface, and
alteration in joint contour (Waldron, 2009). If only one of the latter criteria is present, diagnosis of
OA is dubious, as it has been observed that isolated indicators can occur independent of the disease
(van der Kraan & van den Berg, 2007).
3.5 Osteoarthritis and Other Diseases
Osteoarthritis is the most common joint disease. As such, it often results in association or as a
complication of other diseases (Waldron, 2009), not all of which can be discussed fully here. The
following are some examples that are pertinent to the examination of osteoarthritis in archaeological
remains: Paget’s disease of bone, calcium pyrophosphate deposition disease, and intervertebral disc
disease.
Paget’s disease of bone (PDB) is characterized by accelerated production of remodeled bone,
with hyperactivity of osteoblastic and osteoclastic functions (Cundy & Reid, 2012; Ralston &
Layfield, 2012). Clinical studies have shown a high association between PDB and secondary OA
(Ralston, 2008; Cundy & Reid, 2012). PDB when focused on joint margins may actually accelerate
the course of OA in the affected joint (Helliwell, 1995). This association is likely due to the
alteration of normal cellular and metabolic activity in the joint dynamics (Ralston, 2008). PDB is a
14
rare disease and its diagnosis in archaeological assemblages is difficult and uncommon (Waldron,
2009).
Calcium pyrophosphate deposition disease (CPDD) is sometimes misclassified as
osteoarthritis (Rothschild, 1997). In this arthropathy, calcium pyrophosphate dihydrate (CPP)
crystals are deposited in tissues, most commonly fibrocartilage and hyaline cartilage, and may ossify
as spicules (Ferrone et al., 2011). It is still unclear whether the deposition of crystals contributes to
the pathogenesis of OA, or if the crystals are a result of the joint degeneration (Ferrone et al., 2011).
CPDD has been distinguished from OA in a skeletal collection by a reflective calcified sheet on the
articular surface (Rothschild, 1997).
Some of the changes observed in osteoarthritis also occur on vertebral bodies afflicted with
intervertebral disc disease (IVD). The intervertebral discs situated between the vertebral bodies of the
spine act as cushions that allow mobility and weight absorption. In IVD, the disc will tend to bulge
outward and collapse because of the normal aging process (Waldron, 2009). Marginal osteophytes
may develop around the vertebral body rim both superiorly and inferiorly, accompanied by pitting of
the vertebral body surfaces (Prescher, 1998). These symptoms most commonly occur in the cervical
and lumbar regions, areas of maximum curvature and shock absorption (Bridges, 1994). It is
important to note that osteophytes are not exclusive indicators of OA, but may develop in a multitude
of situations such as IVD. Spinal degenerative joint disease is evaluated in relation to both IVD of
the vertebral bodies and OA of the synovial portions of vertebrae (see section on Spinal Degenerative
Joint Disease).
3.6 Summary
The understanding of osteoarthritis is far from complete. What is certain is that the
pathogenesis of OA is multifactorial, involving mechanical, cellular and biochemical agents. Age,
genetics and obesity are strong risk factors for the development of OA, although the latter is of little
concern in prehistoric populations. Genetics may be difficult, if not impossible, to control in
archaeological studies, but by limiting the sample to one geographical region and collecting a large
enough data set, the influence of this variable in comparisons may be reduced. By focusing on the
mechanical contributions to OA aggravation, anthropologists can make more grounded inferences of
past human activities.
Eburnation is considered pathognomonic of osteoarthritis (Rothschild, 1997; Weiss &
Jurmain, 2007). In its absence, the presence of two of the following indicators strongly suggests OA
of a joint: marginal osteophytosis, new bone on the joint surface, pitting on the joint surface, and
alteration in joint contour (Waldron, 2009). OA can result as a complication of other diseases or
trauma. Its most probable differential diagnosis in archaeological remains is integral to the quality of
conclusions drawn from studies. Despite the limitations discussed above, the paleopathological study
of OA can provide archaeologists a wealth of information on gender roles, occupational stress, and
social status differentiation. The need for further study of OA past and present is warranted.
Because OA is diffuse throughout the joints of the body, a specific anatomical region may be
observed for lesions indicative of OA. The region of concern here is the vertebral column. As is
15
demonstrated in the following section, spinal degenerative joint disease (or spinal OA) is attributed
to the factors described above with the inclusion of axial load bearing (Sandness & Reinhard, 1992;
Lotz & Loeser, 2012; Novak et al., 2012). Its utility in assessing quality of life must be evaluated
with respect to spinal anatomy and biomechanics, as well as the qualities of spinal degeneration.
16
CHAPTER 4. SPINAL DEGENERATIVE JOINT DISEASE
4.1 Introduction
The spine is an important load bearing structure in the body (Fujiwara et al., 2000; Niosi &
Oxland, 2004; Laplante & DePalma, 2012). It serves to protect the delicate spinal cord and restrict
movement of the thorax for proper bipedal locomotion (Bridges, 1994; Niosi & Oxland, 2004;
Laplante & DePalma, 2012). Majority of the weight from the upper body is supported by the natural
curvature of the spine acting as a spring and maintaining the necessary center of gravity for balance
(Platzer, 2004). This is in addition to the cushioning effects of the intervertebral discs (Prescher,
1998; Ustundag, 2009). Several degenerative changes occur to the bony and cartilaginous structure
as a consequence of age, sex, strenuous activity and other factors. Its role in weight bearing is also a
strong contributing factor (Laplante & DePalma, 2012).
A common theme in bioarchaeological research is the estimation of health, physical stress
exposure, and quality of life from skeletal remains (Faccia & Williams, 2008). Physical
anthropologists have used the bony changes in the spine in an attempt to assess these factors
(Sandness & Reinhard, 1992; Stirland & Waldron, 1997; Hukuda et al., 2000; Rojas-Sepulveda et
al., 2008). The findings are often cited in more thematic explorations of prehistoric social
stratification, subsistence strategies, political organization, gender roles and other such macroscopic
aims. As stated above, increased physical stress and load bearing of the spine can aggravate its
degeneration. This makes the spine particularly useful for these kinds of endeavors (Sandness &
Reinhard, 1992). This paper explores pertinent aspects of spinal anatomy, degenerative changes of its
constituent parts, osteological criteria for the diagnosis of spinal degenerative joint disease, and the
limitations of the spine in archaeological inquiries. The objective is to consider spinal degenerative
joint disease and its role in bioarchaeology.
4.2 Anatomy of the Spine
The human vertebral column consists of seven cervical, twelve thoracic, and five lumbar
vertebrae. Five additional fused sacral elements follow the fifth lumbar. Individual vertebral elements
increase in size caudally with a narrowing of the neural arch foramina. Some discussions also include
the three to four fused coccygeal vertebrae, which are rudimentary elements that follow the sacrum.
Most investigations into spinal arthropathies only include the cervical, thoracic and lumbar vertebrae
(Sandness & Reinhard, 1992; Hukuda et al., 2000), and may sometimes include the superior face of
the first sacral segment (Papadakis et al., 2010; Novak & Slaus, 2011; Burke, 2012).
The typical vertebra is comprised of two main parts: the body and the neural arch (Fig. 4.1).
The vertebral body extends posteriorly into the anterior portion of the neural arch, the pedicles. The
pedicles continue to arch posteriorly, now called the laminae, and join from left and right sides to
form the spinous process. At the junction where the pedicles and laminae meet are laterally extending
transverse processes. Also at this junction are two sets of articular facets, one superior set and one
inferior set. These are called zygapophyseal facets, apophyseal facets, or simply articular facets,
which accommodate the inferior facets of the vertebral element above and affix into the superior
17
facets of the vertebra below. Between each of the vertebral bodies, apart from the articulation
between the atlas and axis, is an intervertebral disc which acts as a gelatinous-like padding. The
entire tower-like column is held in place by a series of ligaments. Thoracic vertebral bodies possess
laterally placed facets for the rib heads, and facets on the transverse processes for the costal
tubercles.
The typical curvature of the adult
spine in sagittal view is characterized by an
S-shape, with cervical lordosis, upper
thoracic kyphosis, lower thoracic and lumbar
lordosis, and sacral kyphosis. The curvatures
are well marked much after infancy because
of the erect postures involved in sitting and
standing throughout life (Platzer, 2004).
Flexion, extension and lateral flexion occur
Figure 4.2. Various features of a typical thoracic vertebra. Superior
primarily in the cervical and lumbar spines,
view, anterior is up (left). Lateral view, anterior is left, superior is
while rotation is mainly possible through the
up (right). Modified from Netter, 2006: Plate 154.
thoracic and cervical regions. Regions of
greater mobility are more subject to damage and injury from mechanical overloading (Platzer, 2004).
The intervertebral discs each comprise of an outer layer called the anulus fibrosus and an
inner nucleus called the nucleus pulposus. The anulus
fibrosus is made up of concentrically arranged
fibrocartilagenous and collagen fibers held in strong
tension. It encapsulates the viscous nucleus pulposus,
which primarily serves as a shock absorber (Prescher,
1998; Ustundag, 2009). The entire disc is held firmly in
place by Sharpey’s fibers, which insert at the margins of
the vertebral bodies (Waldron, 2009), and acts as a
ligament holding the vertebral bodies together and
allowing slight movement. Unilateral stretching or
compression is involved when the spine is in motion. The
deterioration of the intervertebral discs has been proposed
as the primary cause for the degeneration of the vertebrae
(Prescher, 1998). Studies have shown that disc
degeneration generally precedes arthritic facet changes
(Niosi & Oxland, 2004).
The various ligaments of the vertebral column are
put in place to support and strengthen the vertebral
articulations (Fig 4.2). They also serve to facilitate the
proper movement of the spine. The anterior longitudinal
ligament runs down anterior to the vertebral bodies,
beginning at the anterior tubercle of the atlas and ending at
the sacrum. It expands caudally, and affixes firmly onto
the vertebral bodies, but only loosely overlaps the
Figure 4.3. (1) Anterior longitudinal ligament,
(5) ligamenta flava, (7) intertransverse ligaments,
(8) interspinous ligaments, (9) spinal processes,
(10) supraspinous ligaments, (12) superior and
(13) lateral costotransverse ligaments, (14)
radiate ligament of the rib head. Modified from
Platzer, 2004: 57.
18
intervertebral discs (Platzer, 2004). Long and short perivertebral bands parallel to the lateral sides of
the anterior longitudinal ligament link adjacent intervertebral discs. Opposite the anterior aspect of
the vertebral bodies is the posterior longitudinal ligament, which runs down the posterior vertebral
bodies. Unlike its anterior counterpart, the posterior longitudinal ligament narrows as it approaches
the sacrum from the atlas. In the thoracic and lumbar regions, this ligament expands at the
intervertebral discs and attaches to the discs and superior vertebral rims (Platzer, 2004). The two
longitudinal ligaments serve to stabilize movement during flexion and extension, and protect the
intervertebral discs (Platzer, 2004). The ligamenta flava attach between the neural arches of the
vertebrae surrounding the vertebral foramen. They are held in constant tension and help return the
spine to an erect position after flexion (Platzer, 2004). Short intertransverse ligaments and
interspinous ligaments attach between the transverse processes and spinous processes of adjacent
vertebrae, respectively. The supraspinous ligaments originate at the tip of the seventh cervical
vertebra and continue downward to the sacrum, attaching at the subsequent spinous processes. The
ligamentum nuchae attaches from the external occipital crest to the cervical spinous processes. Costal
elements are held in place on thoracic vertebrae by the superior costotransverse ligaments, lateral
costotransverse ligaments and radiate ligaments of the rib heads (Platzer, 2004). At each of these
ligament attachments there is the potential for osteophyte formation (Hukuda et al., 2000).
Although there are only two types of joints involved in the spine (symphyseal and synovial),
there are many points of articulation involved between vertebrae, and between the thoracic vertebrae
and ribs. The first type can be found at the intervertebral discs, which are each sandwiched between
two hyaline cartilage plates. The intervertebral symphysis, together with the longitudinal ligaments,
allows some movement. The second type is synovial joints found between the zygapophyseal facets,
uncovertebral joints, atlanto-occipital joint, atlanto-axial joint, lumbosacral joint, and costovertebral
joints. Tension levels in these areas increase caudally. Zygapophyseal joints in the cervical vertebrae
contain meniscoid folds, which allow greater load bearing amidst more lax articulations relative to
the thoracic and lumbar regions (Platzer, 2004). Despite being
synovial joints, movement is only slight. The collective
movement of consecutive zygapophyseal joints and
intervertebral symphyses results in greater mobility of the
thorax. Specific to the cervical vertebrae, the uncovertebral
joints or Luschka’s joints are formed between the uncinate
processes at the superior posterolateral rims of the cervical
bodies articulating with the inferior cervical bodies above
(Hayashi & Yabuki, 1985) (Fig. 4.3). The joint space of the
uncovertebral joint begins to extend slightly into the
intervertebral disc at the age of nine or ten, but may eventually
extend across the entirety of the disc causing pulposus
herniation (Platzer, 2004) (Fig. 4.4). The atlas laxly articulates
superiorly with the occipital condyles, and inferiorly with the
articular facets and dens of the axis. The slack and incongruent
articulations provide greater movement of the skull. The
Figure 4.4. Uncovertebral joint between the
lumbosacral joint involves the synovial articulation between
C6 and C7 (top). Uncovertebral joint
the fifth lumbar and first sacral segment. In some cases, the
enlarged (bottom). Anterior view. Modified
lumbar vertebrae will variably fuse to the sacrum (Konin &
from Platzer, 2004: 59.
Walz, 2010). Ribs are also joined to thoracic vertebrae through
19
costovertebral synovial joints. Aside from the first, eleventh and twelfth ribs, rib heads articulate
partly on the upper and lower margins of adjacent vertebrae. The costal tubercle articulates with the
transverse process of the thoracic vertebra via a synovial joint, except in the eleventh and twelfth ribs
where costotransverse joints do not typically exist. The mobility of the rib cage partly owing to the
costovertebral joints is required for respiration (Platzer, 2004). A thorough understanding of vertebral
anatomy is a prerequisite for the appreciation of degenerative changes afflicting the spine.
4.3 Degeneration of the Spine
Spondyloarthropathies, or pathologies of the spinal joints, target the different points of
articulation just described. These changes are typically associated with normal aging, but sex, body
mass, genetic predisposition, previous trauma and physical activities are all intricately involved
(Prescher, 1998; Weiss & Jurmain, 2007; Pouletaut et al., 2010; Zukowski et al., 2012; see section
on the Aetiology and Pathogenesis of Osteoarthritis).
The nucleus pulposus gradually becomes more fibrous
with age, losing internal pressure, viscosity and height, and
shrinks. As a result, the tension of the annulus fibrosus
decreases and the fibrocartilage and collagen fibers tear
(Prescher, 1998; Niosi & Oxland, 2004; Platzer, 2004; SarziPuttini et al., 2004). This results in a more crumbled, solid-like
disc and an annulus fibrosus with multiple clefts and fissures
(Niosi & Oxland, 2004; Wilmink, 2011). Blood vessels may
Figure 4.5. Fissure across the intervertebral
disc originating from the uncovertebral
penetrate the failing disc and consequently initiate ossification
joint space. Anterior view. Modified from
(Prescher, 1998). The disc loses its ability to distribute and
Platzer, 2004: 59.
absorb loads through compression and expansion (Sarzi-Puttini
et al., 2004). This can cause several secondary effects on the osseous and cartilaginous elements of
the intervertebral symphysis such as changes to the body surface contour, osteophytosis of the
vertebral rim, vertebral body sclerosis, and ossification of associated ligaments (Lipson et al., 1985;
Prescher, 1998; Niosi & Oxland, 2004; Watanabe & Terazawa, 2006). In some cases, osteophytes
from adjacent vertebral bodies will contact each other and kiss, coalesce or completely fuse (Maat et
al., 1995; Sarzi-Puttini et al., 2004). Afflicted uncovertebral joints are characterized by osteophytes
on the uncinate processes (Sarzi-Puttini et al., 2004). Occasionally, osteophytes originating from the
body and uncinate process may protrude into the intervertebral foramina and can cause compression
of the nerve roots and vertebral artery, particularly in the cervical spine (Prescher, 1998; Waldron,
2009). Histological inspection of degenerated intervertebral discs shows comingled fragments of
hyaline cartilage, fibrocartilage, nucleus pulposus, and acute and chronic inflammatory cells (Lipson
et al., 1985), indicating that multiple tissues are damaged through this process of degeneration.
The intervertebral disc can displace and herniate in any direction. When the nucleus pulposus
herniates into the adjacent vertebral body either superiorly or inferiorly, penetrating the cartilagenous
endplate, the resulting lesion is known as a Schmorl’s node. Although the process of Schmorl’s node
formation is understood, the causes are still contentious (Burke, 2012). As with most primary
degenerative joint diseases, the etiology of Schmorl’s nodes is considered multifactorial. However,
age is not usually considered a factor (Dar et al., 2009; Burke, 2012). It is generally thought that the
20
weakening of the cartilaginous endplate or the vertebral body itself facilitates the herniation of the
nucleus pulposus (Peng et al., 2003; Dar et al., 2009; Burke, 2012). Compromised endplates are
unable to withstand the pressures exerted by the nucleus pulposus. Wagner et al. (2000) attributed
increased nuclear pressure to acute axial loading. They are also commonly encountered in regions
exposed to more rotational forces (i.e. the thoracic spine) and have thinned intervertebral discs
(Ustundag, 2009). Repetitive and generalized physical stress, especially involving flexion of the
spine, has been associated with higher incidences of the lesions (Burke, 2012). Schmorl’s nodes have
been observed more frequently in men than in women, likely due to heavier load bearing in male
spines (Lipson et al., 1985; Prescher, 1998; Sarzi-Puttini et al., 2004; Dar et al., 2009).
The zygapophyseal facets are true synovial joints and suffer from the identical degenerative
changes of osteoarthritis seen in other synovial joints. They are main facilitators for flexionextension movements and prevent excessive torsion. There is also evidence to suggest they are
important in load bearing functions (Fujiwara et al., 2000). Their role in movement and stability
precipitates and accelerates facet osteoarthritis. This is particularly true for the cervical and lumbar
regions (Prescher, 1998; Sarzi-Puttini et al., 2004), although thoracic involvement has been observed
in prehistoric samples (Bridges, 1992). The differences may be because of varying postures,
activities and methods of load bearing (Bridges, 1992). Moreover, added stability from the ligaments
of the costovertebral articulations may explain the decreased severity of symptoms in the thoracic
spine (Sarzi-Puttini et al., 2004). The loss of disc height mentioned above secondarily results in
malalignment and increased load bearing of these facets, leading to stressed joint capsules and
ultimately degenerative changes (Sarzi-Puttini et al., 2004; Wilmink, 2011). Similar to the osseous
changes involved in intervertebral disc disease, degenerated zygapophyseal facets change in
morphology. Changes include widening of the joint surface contour, sclerotization and new bone
formation, pitting of the joint surface, the development of marginal osteophytes, and most notably
eburnation (Sanzhang & Rothschild, 1993; Lovell, 1994; Stirland & Waldron, 1997; Waldron, 2009;
Rojas-Sepulveda, 2008). Osteophytes from the zygapophyseal facets can also project into the
intervertebral foramina, compressing the nerve roots and vertebral artery (Muto, 2011).
Osteoarthritis of the costovertebral and costotransverse joints is not regularly emphasized in
the literature. In fact, little attention is given to them in both clinical and archaeological studies. This
could be ascribed to their more recognized involvement in rheumatoid arthritis, seronegative
spondyloarthropathies and diffuse idiopathic skeletal hyperostosis (Rothschild & Woods, 1991;
Arriaza, 1993; Sanzhang & Rothschild, 1993; Sales et al., 2007). Sales and colleagues (2007) note
that osteoarthritic costovertebral joints are a rare occurrence outside these disorders, but are still
susceptible to the usual osteoarthritic symptoms from excessive movement and pathological loading.
The various ligaments in place to stabilize the vertebral column are also susceptible to
damage from pathological deformations of the osseous elements and strenuous physical exertions. In
some cases, these ligaments, especially the ligamenta flava and longitudinal ligaments, ossify. It has
been suggested by Mine and Kawai (1995) that the mechanism of ossification is as follows. The
fibers of ligamentous tissues are thinned and torn, and subsequently invaded by capillaries and
undifferentiated mesenchymal cells. These cells transform into osteoblasts and osteogenesis ensues.
The ligamentous fibers thus calcify and ossify. However, the initial ruination of normal ligamentous
tissue is not exclusive to osteoarthritic or intervertebral degradation. Wear and tear of ligaments can
result from any number of diseases or traumas involving pathological stress of the normal functions
21
of the spine (Arriaza, 1993; Maat et al., 1995; Hukuda et al., 2000). Its inclusion in the assessment
and diagnosis of spinal osteoarthritis may still be valid in association with other more diagnostic
criteria as see in the work of other researchers (e.g. Lovell, 1994; Dawson & Trinkaus, 1997; Stirland
& Waldron, 1997; Fujiwara et al., 2000; Hukuda et al., 2000; Zukowski et al., 2012).
4.4 Diagnosing Spinal Degenerative Joint Disease
Although the clinical definition of osteoarthritis limits its scope to synovial joints (Bridges,
1994; Waldron, 2009; Laplante & DePalma, 2012), the entire spinal anatomy must be given
attention. Several paleopathological investigations include alterations to the vertebral body as well as
the zygapophyseal facets (e.g. Sandness & Reinhard, 1992; Bridges, 1994; Lovell, 1994; Stirland &
Waldron, 1997; Hukuda et al., 2000; Rojas-Sepulveda et al., 2008; Novak & Slaus, 2011). Indeed,
even clinical evaluations of spinal osteoarthritis include changes to the vertebral symphyses (e.g.
Fujiwara et al., 2000; Niosi & Oxland, 2004; Sarzi-Puttini et al., 2004) since the two types of joints
are incontrovertibly linked, and work in tandem throughout the vertebral column to provide
movement and support. Furthermore, the two parts share similar osseous changes (e.g.
osteophytosis, joint contour changes, surface porosity, sclerotic margins) and etiological factors (e.g.
age, sex, physical stress). Vertebral bodies and zygapophyseal facets should not be investigated
separately.
To keep in line with clinical definitions of osteoarthritis, I suggest the term spinal
degenerative joint disease to incorporate both the synovial facets and vertebral symphyses. Adapting
Waldron’s (2009) operational definition for osteoarthritis, the differential diagnosis of spinal
degenerative joint disease should include two manifestations of either marginal osteophytosis,
changes to the joint contour, surface porosity and sclerotic new bone for both the vertebral body and
zygapophyseal facets. Eburnation should remain as a pathognomonic indicator of osteoarthritis
exclusive to the facets. Schmorl’s nodes are pathognomonic of compromised vertebral endplates, and
are highly indicative of great axial stresses placed on the lower spine (Sward, 1992; Wagner et al.,
2000; Kyere et al., 2012). They too should be given attention. Ligamentous ossifications should be
documented, but never used as the sole indicators for degenerative joint disease as they are also
highly associated with other diseases such as diffuse idiopathic skeletal hyperostosis (Arriaza, 1993;
Hukuda et al., 2000).
4.5 Limitations to the Study of Spinal Degenerative Joint Disease
Paleopathology is not without its limitations. Because of lack of well-documented contexts,
archaeological investigations must make necessary inductions from the available evidence. The
insufficiency of standardized methods and criteria also hinders comparisons between studies. Some
important limitations to the use of spinal degenerative joint disease in assessing prehistoric lifeways
are discussed: the differences in methods of scoring and diagnosis, the uncertainty of anthropological
aging, and the often absence of clinical and historical documentation.
There is a wide variability in the methods for scoring archaeological vertebral degenerative
joint disease, and no apparent consensus between researchers. Because of varying methods in the
22
definition, scoring, diagnosis, and statistical computation of osteoarthritis between different
researchers, results between studies are often incomparable (Bridges, 1993). In an attempt to appeal
to this variety, Rojas-Sepulveda et al. (2008) compared five commonly used diagnostic methods on a
Pre-Columbian Colombian series. ‘At least one’ considered one vertebra, one whole region, or one
whole column “positive” for the disease if it presented at least one diagnostic criteria (osteophytes,
body joint surface contour change, body pitting, zygapophyseal joint surface contour change,
zygapophyseal pitting or eburnation). ‘Two together’ considered eburnation as pathognomonic. If
eburnation was not present, any two other manifestations (osteophytes, joint surface contour change,
pitting) on the same vertebra would have made a positive diagnosis. If one vertebra was positive
(either by eburnation alone, or from two other criteria on the same vertebra), the corresponding
region and entire vertebral column was also positive. ‘Two separated’ is a variation of the previous,
where eburnation is still pathognomonic, but in its absence, any two other manifestations were used
for a positive diagnosis, but need not be found on the same vertebra. Any isolated vertebrae were not
classified as positive in this scoring system. ‘Only eburnation’ considered eburnation as the sole
positive indicator. ‘Pitting excluded’ is a variation of ‘At least one’ except pitting alone was not
enough for a positive classification. The results showed “Pitting excluded” as the best of the five for
the Colombian assemblage, because pitting seemed to be ubiquitous in both sexes and all age groups
at all vertebral regions, affirming Rothschild’s (1997) suggestion that porosity be eliminated as a
diagnostic criterion. However, Rothschild’s (1997) contention fails to offer an explanation for the
high correlation between pitting and eburnation. To summarize, pitting or porosity is a viable
indicator of degenerative changes when in association with other markers. The lesions most likely
represent osteopenic subchondral trabeculae and increased osteoclastic resorption directly beneath
the subchondral bone plate as a result of instability-related pathologies (Dedrick et al., 1997; Botter
et al., 2011).
The anthropological assessment of skeletal ages has always been an approximation,
especially in adult remains. This is a major limitation on the osteological study of degenerative joint
disease, because the disease is highly correlated with age (Jurmain & Kilgore, 1995; Ruhli et al.,
2005; Pouletaut et al., 2010; Zukowski et al., 2012). An obvious attenuation of the inaccuracy, but
not a cure for it, is a multifactorial approach. When multiple aging criteria are available for
approximation, all of them should be used as a comprehensive procedure has been shown to be the
most accurate method (Baccino et al., 1999). Methods involving age estimation from the vertebrae
should be excluded, as these elements are the dependent variables under study. In addition, the
assignment of individual skeletons into standardized age cohorts as suggested by Buikstra and
Ubelaker (1994) will allow more valid inter- and intra-population comparisons. For adult skeletons,
the age categories most commonly used are young adult (20-35 years), middle adult (35-50 years),
and old adult (50+ years) (Buikstra & Ubelaker, 1994).
An obvious shortcoming of archaeological materials is the lack of accompanying historical
and clinical records. The assumption of decreased quality of life being proportionate to the severity
of degenerative changes is partly undermined by modern reports of asymptomatic spinal pathologies
(e.g. Sarzi-Puttini et al., 2004; Sales et al., 2007; Dar et al., 2009; Wilmink, 2011; Laplante &
DePalma, 2012). Archaeological contexts also often lack necessary ethnographic data. For
prehistoric populations, the specific activities of these peoples can only be induced from their
material culture and patterning of bony changes. However, the precision to which we can estimate
specific activities, the intensity of such activities, and the duration of actions is dubious. The
23
common assumption is that differences in frequency and severity between groups (e.g. different
sexes, social classes, and time periods) can be explained by differences in behaviour and activity.
The inconsistent contemporary epidemiological results correlating activity and degenerative joint
disease prompt Jurmain and Kilgore (1995: 446) to argue that “any such attempts extended to the
much less well-documented archaeological past represent an extremely hazardous intellectual
venture.” In addition, the genetic predisposition of a small portion of the population to form excess
bone, such as more severe osteophytes even in normal conditions, may muddle interpretation (Rogers
et al., 1997). Molleson (2007) cautions the necessity for proper documentation, inclusion of a
differential diagnosis, comparisons to equivalent normal samples, and review of independent
environmental or comparative evidence when estimating activity from skeletal morphologies.
4.6 Summary
The application of spinal degenerative joint disease is not without problems. Nevertheless, it
has value in answering several archaeological questions, particularly those assessing past human
lifestyle and activity. Age is usually equated with degenerative changes. However, it is not the only
precipitating factor. Much of the variances in degenerative changes seen in the human spine can be
attributed to the biomechanical forces at play (Prescher, 1998). This is likely why the most distinct
changes occur in regions of maximum curvature (Bridges, 1992; Bridges, 1994; Novak & Slaus,
2011), movement (Bridges, 1992; Prescher, 1998), and load bearing (Lotz & Loeser, 2012; Novak et
al., 2012). Careful considerations of spinal anatomy and its degenerative processes will illuminate
the utility of the spine in assessing prehistoric quality of life. In addition, the archaeological context
is necessary in linking physical observations of bony lesions to meaningful interpretations of past
human activity. With respect to San Jose de Moro and the Moche, the archaeological context
provides a unique opportunity to evaluate the physical differences in quality of life as manifested by
SDJD between discrete social classes expressed through mortuary evidence. An understanding of
Moche sociopolitical organization and religious belief provides a backdrop for which the osteological
evidence can be given meaning.
24
CHAPTER 5. THE ARCHAEOLOGICAL CONTEXT OF SAN JOSE DE MORO
5.1 Introduction
The Moche (or Mochica) of ancient Peru
remain a mystifying culture despite decades of
archaeological research. First discovered by Max
Uhle in the 19th century, this prehistoric
civilization is best described as a society with a
complex sociopolitical structure and rich religious
iconography. Research terms into warfare, social
stratification, human sacrifice, ceramic technology,
metallurgy, monumental architecture, urbanism,
irrigation, and artwork have become synonymous
to Moche. They were the dominant culture of the
Peruvian North Coast during the Early Intermediate
Period and Middle Horizon of Andean prehistory,
approximately AD 100 to AD 800 (Sutter &
Cortez, 2005; Chapdelaine, 2011; Villacorta
Ostolaza, 2012).
Until recently, the Moche were thought to
consist of one united polity that later developed
state-level organization, with its capital at Huacas
de Moche in the Moche Valley (Pillsbury, 2001;
Castillo & Quilter, 2010). This paradigm has
undergone revision, and currently most researchers
agree that two Moche polities in the north and
Figure 5.1. Regional map of Peruvian north coast with
south existed as distinct cultural spheres separated
major Moche sites, and geographic division of northern
by the Paijan Desert (Castillo & Donnan, 1994a;
and southern cultural spheres. Taken from Chapdelaine,
Patterson, 2004; Castillo & Uceda, 2008) (Fig. 5.1). 2011: 194.
The northern Moche region encompassed the
Jequetepeque and Lambayeque Valleys, and had influences extending further north in the Piura
Valley (Chicoine, 2011). The southern Moche sphere included the Chicama and Moche Valleys,
expanding territorial control south into the Viru, Chao, Santa and Nepena Valleys through warfare
(Castillo, 2001). The growing body of archaeological data is in support of this newer model. Because
of this development, the Moche can no longer be considered as a consolidated culture, but portray
individual polities that share common religious and sociopolitical elements (Bawden, 1996).
The site of prime interest is San Jose de Moro, located in the Jequetepeque Valley in the
northern Moche territory. While San Jose de Moro was occupied for more than a thousand years
beginning in the Middle Moche period right up to Inca conquest, the San Jose de Moro
Archaeological Project has focused on Late Moche development, one of its most dense deposits
(Castillo, 2001). The site served as a cemetery and ceremonial center, continually occupied for much
longer periods in comparison to neighboring habitational sites such as Pampa Grande and Galindo
25
(Nelson, 1998; Castillo, 2001). Consequently, San Jose de Moro has made great contributions to our
understanding of Moche funerary practice, sociopolitical organization, and societal collapse. This
paper reviews the archaeological context of the Moche including environmental context, chronology
and sociopolitical organization with an emphasis on funerary patterns and social stratification at the
ceremonial cemetery site of San Jose de Moro.
5.2 Environmental Context
The Moche occupied the coastal strip of northern Peru between the Pacific Ocean and
Andean Cordillera. The environment is typically that of a hyperarid desert with little to no rainfall. A
series of river valleys are dispersed throughout the coast, and as can be expected, Moche sites are
usually clustered around these rivers. Agriculture was made possible by the waters running down
from the Andean mountains to the east. To the west, the Peruvian Coastal Current (or Humboldt
Current) fostered a rich marine environment, as it does today. Indeed, Moche subsistence took
advantage of both cultivatable lands and maritime resources (Sutter & Cortez, 2005; Swenson, 2007;
White et al., 2009). Periodic El Niño Southern Oscillation (ENSO) events would cause dramatic
shifts in the weather, bringing torrential rains, floods, and migration of marine ecosystems. The
implications of these ENSO events have been incorporated into the larger picture of the Moche
cultural landscape (e.g. Hill, 2003; Huchet & Greenberg, 2010; Taggart, 2011). Its role in the
collapse of Moche society will be discussed in more detail below.
5.3 Chronology
Although Uhle was the first to discover the Moche and begin archaeological excavations at
Huacas de Moche, it was Rafael Larco Hoyle who first dedicated his life to studying the Moche
(Villacorta Ostolaza, 2012) and is considered the father of Moche archaeology (Castillo & Quilter,
2010; Chapdelain, 2011). Larco Hoyle (1948) developed a five-phase chronology for the Moche
largely based on changes in the iconic stirrup-spout of Moche pottery (Donnan, 1976; Shimada,
1994) (Fig. 5.2). This seriation was widely used, and its credibility was later verified through
radiocarbon dating, becoming instrumental in dating strata from all across the southern Moche coast
(Chapdelaine, 2011; Chicoine, 2011).
This system was based solely on
ceramic vessels collected from the southern
sphere. However, with the division of the
Moche into the north and south, its application
in the northern sphere is dubious. In response, a
new sequence has been developed for the
Jequetepeque Valley, where Early, Middle, and
Late Moche and a Transitional Period replace
Figure 5.2. Changes in stirrup-spout form from Moche Phase I
through V. Taken from Donnan, 1976: 45.
the five phases of the south (Castillo &
Donnan, 1994a) (Fig. 5.3). Other northern
valleys do not have such a modified chronology yet, but the Jequetepeque sequence is assumed
representative of the northern region thus far (Chapdelaine, 2011). Nevertheless, the ceramic
26
chronologies for the northern and southern Moche are incongruent and more work is needed to
solidify the equivalences between them. It is only by consensus that scholars allot a range between
100 AD and 300 AD for the beginning of Moche Phase I in the south and Early Moche in the north,
but in reality, the actual beginnings are still ambiguous (Chapdelaine, 2011). The Middle Moche
begins relatively contemporaneously with Moche Phase III in the south, and partly continues with
Moche Phase IV. It is during the final stages of Moche Phase III that drastic stylistic differences are
evident between the north and south (Chapdelaine, 2011). The Late Moche in the Jequetepeque
Valley corresponds to the latter portion of the southern Moche Phase IV and all of Phase V. Several
radiocarbon dates from across the valleys, especially at Huacas de Moche, support Larco Hoyle’s
(1948) original seriation (Chapdelaine, 2011).
For the Jequetepeque Valley,
centralized settlement began in the
Early Moche Period at Dos Cabezas
(Donnan, 2007). The Moche expanded
their territories in two subsequent
stages north and south by the Middle
Moche Period (Castillo, 2010b) (Fig.
5.4). Occupation at San Jose de Moro
begins in the Middle Moche (Castillo
& Donnan, 1994b; Castillo, 2001;
Zori, 2011), accurately corresponding
to the northern expansion of the valley
to which it belongs. The emergence of
autonomous regions and then later
independent polities could have been
spurred by expansion of the irrigation
systems (Castillo, 2010b). San Jose de
Moro seems to have served as a
Figure 5.3. Moche ceramic sequence in the northern and southern
cultural spheres. Modified from Castillo & Uceda, 2008.
communal centre for the surrounding
competing polities (Verano, 2006;
Castillo, 2010b; Chapdelaine, 2011; Taggart, 2011). Its role as a communal ceremonial center for the
valley will be discussed further below.
5.4 Sociopolitical Organization
Jeffrey Quilter (2002) has synthesized Moche political organization into four possible
models: the single state model, the dual kingdoms model, valley states with no centralized authority
model, and a Moche confederation model with Huacas de Moche as its primary center. The single
state model originally proposed by Larco Hoyle (1948) requires a monolithic society, but is now
dismissed due to the establishment of the northern and southern Moche cultural spheres (Castillo &
Donnan, 1994a; Patterson, 2004; Castillo & Uceda, 2008). Agreement beyond dismissal of the first
model is still lacking for the other three models.
27
Figure 5.4. Moche expansion stages in the Jequetepeque Valley. Taken from Castillo, 2010b: 92.
The dual kingdoms model proposes two independent states, one in the north and one in the
south. However, it is doubtful that there was any unity in the north that was comparable to the
situation in the south based on uniformity in craft style (Chapdelaine, 2011). The third model
suggests that sites with large architectural structures such as El Brujo and Huacas de Moche and
those with royal tombs such as Sipan and San Jose de Moro were valley states with no centralized
authority. Sites that demonstrate an amassment of power and resources are considered under this
model as valley states ruled by a king powerful enough to be politically independent. The fourth
model is similar to the third, except that there was some centralization with Huacas de Moche as its
capital. This is spurred by the unmatched size and complexity of Huacas de Moche, being the largest
site of its time. A comparable candidate for a political capital is Pampa Grande, but the site only
emerged towards the very end of Moche chronology (Shimada, 1994). The site of Galindo replaced
Huacas de Moche as a center, adopting the Moche Phase V ceramic style that was never introduced
at Huacas de Moche (Lockard, 2009). Galindo seems to have been developing contemporaneously
with the gradual decline of Huacas de Moche (Lockard, 2009). The northern sphere did not seem to
be as united as it was in the south. Therefore, a reformulation of the dual kingdoms model that
describes the south as a unified Moche state and the north as a collection of valley states seems most
appropriate.
28
The sociopolitical organization of the Jequetepeque Valley differs from that of other regional
centers, as it seems to present a mix of regional polities and a centralized state (Catillo, 2010).
According to Castillo (2010) and Johnson (2011), the valley was comprised of a number of
autonomous political and economic entities, as expressed by different regional material culture and
stylistic variation. These separate regions underwent independent cultural evolutions. Defensive
sites, such as Cerro Chepen, San Ildefonso, and Cerro Catalina, indicate elements of hostility
between the relationships of these polities (Swenson, 2007, 2011). Despite episodes of contention, a
sense of uniformity was sustained by valley-level integration through ritual celebration and burials of
their elites at ceremonial centers such as San Jose de Moro (Millaire, 2002, 2004; Castillo, 2010b).
Collaboration was also necessary in constructing and maintaining primary irrigation systems
(Castillo, 2010b). Therefore, Castillo (2010) claims that “ideology, more than coercion or economics,
was the principal factor fostering social cohesion and cultural harmonization.” The commonalities in
irrigation technologies, iconography and ritual festivities support a centralized system. On the other
hand, defensive architecture and fragmentation of communities suggest autonomous isolation. These
two paradoxical developmental processes appear to be contemporaneous (Castillo, 2010b), but may
have been necessary in ensuring the prosperity of the valley. Indeed, it was the last of the Moche
valleys to disappear from the archaeological record. Thus, the Jequetepeque Valley presents a unique
situation of parallel development of integration and independence.
5.5 Social Stratification and Burial Contexts
Social stratification has characterized majority of Moche archaeology. The necessity for
corporate labour in building their massive huacas and the lavishly adorned burials of a handful of
individuals suggest a strong degree of social differentiation (Millaire, 2002). Because of a ruling
elite, the mobilization of workers was possible on such a large scale for the development of
urbanism, craft production, standardization and trade
(Hill, 2003; Chapdelaine, 2011). There appears to be at
least three social classes (Sutter & Cortez, 2005;
Chapdelaine, 2011), well stratified in a Moche social
pyramid (Fig. 5.5). The base of this pyramid is composed
of commoners involved with the daily tasks of agriculture
and construction. Craft specialists, warriors and
bureaucrats may represent a middle class (Chapdelaine,
2011), who sought to serve specific interests of the upper
class (Makowski, 2008; Bernier, 2010). Finally, the top
of the pyramid is occupied by the Moche elite, which
may have been divided into three subgroups: a lower elite
(regional leaders), an upper elite (high priests and
Figure 5.5. Moche social pyramid. Modified
priestesses), and royalty (lords) (Chapdelaine, 2011).
from Chapdelaine, 2011: 203.
Although majority of elite burials are male, women could
also hold levels of high status, as demonstrated by the tomb of the High Priestess of San Jose de
Moro (Donnan and Castillo, 1992).
The prevailing assumption has been that the amount of resources and construction effort of
graves is directly proportional to status (Donnan, 1995). Thus, large chamber tombs built with adobe
29
bricks and filled with numerous fine ceramic vessels were reserved for higher ranking individuals,
while those burials involving simple pits and few to no material offerings were allotted for the lower
class. Three main types of burials have been identified at San Jose de Moro: simple pit burials, bootshaped tombs, and rectangular chambers made with adobe bricks (Nelson, 1998; Millaire, 2002,
2004; Huchet & Greenberg, 2010).
Simple pits are typically small graves, often a size large enough for only one individual laid
to rest in an extended position. Individuals interred in simple pit burials are accompanied with few to
no grave goods. These burials are likely associated with lower class commoners. There is some
evidence to suggest that the grave goods associated with a burial may indicate the principle activities
during life of those interred (Millaire, 2002; Chicoine, 2011). One association has been found with
female graves and spindle whorls and bundles of yarn, proposing that women were actively involved
in spinning yarn and weaving fabrics (Donnan, 1995).
The boot-shaped tomb gets its name from the shape of its cross-section, which involves a
vertical shaft descending down and opening into a horizontal chamber for the body (Fig. 5.6). Once
the body is interred, adobe bricks were used to seal off the horizontal portion (Nelson, 1998).
According to Nelson (1998), this burial type has only been described at the Jequetepeque sites of San
Jose de Moro and Pacatnamu. The literature seems to support this distinction (Millaire, 2004; White
et al., 2009). Boot-shaped tombs have been found with multiple individuals interred simultaneously,
such as one of the burials at San Jose de Moro containing a child, adult male and young female
(Castillo & Donnan, 1994b). A larger number of grave goods versus simple pit burials is typical, and
can include fineline ceramics, textiles, copper instruments, Spondylus shells, and llama bones
(Millaire, 2002). These burials likely correspond to an artisan middle class and those with some
influence.
Lastly, the most elaborate burial
structures are composed of rectangular
chambers constructed with adobe bricks.
These were reserved for members of the
highest echelons of Moche society. A
handful of these graves at San Jose de
Moro contained principle women thought
to represent the Priestess of the Sacrifice
Ceremony in Moche iconography (Castillo
& Donnan, 1994b; Taggart, 2011) (Fig.
5.7). This is strongly supported by the
presence of a “sacrificial cup” and pointy
Figure 5.6. A typical Moche boot-shaped tomb from San Jose de Moro
headdress buried with the principle figure,
in cross-section. Figure not to scale. Taken from Nelson, 1998: 195.
elements present in the iconography. The
sacrificial cup and headdress could be tokens of a priestess profession, which were buried with the
priestesses after death. An even more lavish tomb was discovered at Sipan in the Lambayeque
Valley. The individual buried here who has been named the Lord of Sipan has been identified as the
Warrior Priest in Moche iconography (Alva, 2001) (Fig. 7). This is again strongly supported by the
similar material culture and iconographic elements, namely the metal backflaps, conical crescent
helmet, and crescent nose piercing (Swenson, 2003). Bourget (2008) has also proposed that another
30
burial at Sipan may correspond to Character D from the Sacrifice Ceremony (Fig. 5.7). These
discoveries identify the Moche elite as reenactors of specific ceremonies in Moche religion. Other
tombs of comparable construction are of a similar nature with varying degrees of lavishness. These
chamber tombs are filled with numerous fine ceramic vessels, llamas, bracelets, earspools,
ceremonial copper knives, metal artifacts, and a large number of miniature ceramic vessels among
others. In addition, several other human skeletons were also interred with the principle figure,
probably acting as retainers and sacrificial offerings.
There is a growing body of evidence to suggest that tombs were reopened for either reuse by
another individual or placement of secondary offerings (Millaire, 2004; Sutter & Cortez, 2005;
Huchet & Greenberg, 2010). Nelson (1998) has also demonstrated that bodies may have not been
buried immediately after death, but retained outside for considerable time before being interred. The
patterns of disarticulation in the boot-shaped tombs at San Jose de Moro studied by Nelson (1998)
suggest that the bodies were already in an advanced state of decomposition when they were lowered
into the tombs. Imagining this process is reminiscent of the Burial Scene in Moche iconography
(Donnan & McClelland, 1979). The dynamic manipulation and revisiting of human remains by the
Moche indicate a complex ideology and ritual involving death and the dead (Millaire, 2004). Burials
did not serve as mere disposal sites for corpses. Rather, the funerary archaeology of the Moche paints
a complicated picture of social stratification and differentiation as well as an active participation by
the living (Castillo & Donnan, 1994b; Nelson, 1998; Millaire, 2004).
Figure 5.7. The Sacrifice Ceremony scene. Roll-out drawing of a painting on a Moche Phase IV vessel with
labeled characters. Taken from Millaire, 2002: 68.
5.6 Moche Collapse
In order to understand the reasons for Moche collapse, scholars must remember that the
Moche might have never been as unified as previously thought. The existence of several independent
polities implies separate demises for each (Chapdelaine, 2011). Some regions may have experienced
rapid deterioration, while others underwent a more gradual decline. Different sets of factors may
have been involved in collapse of the different states. A case-to-case approach to studying Moche
collapse is thus warranted.
31
Two sets of factors (external and internal) acting in tandem likely caused the ultimate demise
of the Moche, although not simultaneously across all valleys. It is thought that external factors were
only secondary to primary internal distress (Castillo & Uceda, 2008). The primary external factor
was environmental instability, specifically the catastrophic weather brought about by major El Niño
events (Swenson, 2007; Chapdelaine, 2011; Johnson, 2011). However, it is thought that severe
climatic fluctuations were the tipping point to an already waning elite powerbase (Castillo, 2001;
Chapdelaine, 2011). Another external factor would have been invasion, either through the
replacement of ideologies or through territorial expansion by foreign powers (Swenson, 2007). For
the southern Moche, Uceda (2008) believes that at around AD 600 there was a conflict of governance
between the theocratic ruling elite and a growing corporatist urban class (Chapdelaine, 2001). As
Chapdelaine (2011: 211) eloquently states, “erosion of political power and ideology related to
competition within the elite… could best explain the collapse of the southern Moche state”.
The Jequetepeque Valley seems to have been the last stronghold of Moche society, before its
eventual demise around AD 800 (Castillo, 2001; Swenson, 2007). In contrast to the gradual decline
of Huacas de Moche in the south, Moche society at San Jose de Moro in the north experienced a
relatively abrupt collapse even with continual occupation into the Transitional Period (Castillo &
Uceda, 2008). Indeed, the Late Moche Period is best characterized by social unrest (Swenson, 2007),
rigid social inequalities (Swenson, 2011), and collapse (Castillo, 2001). Three contributing factors
are highlighted: environmental distress, foreign influence from the Wari culture of the southern
highlands, and internal turmoil within Moche society (Castillo, 2000, 2001).
Environmental changes have not been extensively studied yet at San Jose de Moro, but
archaeologists are confident climatic instability certainly played a part in the collapse based on
environmental reconstruction of torrential ENSO events (Taggart, 2011). Mortuary archaeology
however has been central to the research at San Jose de Moro. Funerary practices and fineline
ceramic styles change dramatically towards the end of the Late Moche and during the Transitional
Period (Castillo, 2001). This style incorporates Wari-like and Moche-Wari hybrid motifs, further
asserting the effects of external influence. However, no evidence of actual occupation from foreign
invaders has been found at San Jose de Moro during the terminal stages of the Late Moche, either in
terms of foreign tombs or disproportionate amounts of exotic artifacts (Castillo, 2001). Thus, the
archaeological data suggests nonnative influence rather than invasion. In addition, Castillo and
Donnan (1994b) give more focus to internal weaknesses of Moche politics. The self-elevation of an
oppressive elite class that isolated themselves from the common people and hesitated in their duties
of redistribution of goods led to the eventual rebellion of the oppressed (Shimada, 1994; Bawden,
1996).
5.7 Summary
The entirety of Moche archaeology could not possibly be given justice in such a brief
overview. Truly, the Peruvian North Coast is earning its name as the Egypt of South America. Even
so, our knowledge of the Moche is far from complete. Here, emphasis has been given to the
correlation between mortuary archaeology and social stratification. These are the most pertinent
elements for my thesis research, which focuses on inferring the disparity in quality of life between
social classes through the severity of degenerative joint disease in the spine. The mortuary
32
archaeology of San Jose de Moro allows discrete segregation of burial types according to social
status.
It is clear Moche society was highly stratified. Coupled with episodes of environmental
turmoil and the spread of foreign ideology, conflict between the elites and their subjects led to the
eventual demise of this culture. Nevertheless, before their disappearance from the archaeological
record, the Moche were able to leave behind a rich material culture that has informed archaeologists
of ancient sociopolitical organization, iconography and religion, and societal collapse. Their cultural
impacts on the landscape will prompt research questions and long-term field projects for decades to
come.
The investigation of overarching themes such as warfare, politics and religion appear to
dominate Moche literature. Although all researchers agree Moche society was highly stratified, it
would seem little attention has been given to the understanding of different lifestyles among divided
demographic sectors. Beyond simply stating that the ruling elite provided a demand for the
production of crafts, and a growing urban lifestyle fueled the construction of massive agricultural
fields and monumental architecture, a more focused research question must be asked. Does the
apparent stratification that reveals itself through the material culture and iconography likewise reflect
itself in the bones of these people? This is the central idea that this thesis seeks to answer.
33
CHAPTER 6. MATERIALS AND METHODS
6.1 Materials
This thesis explores the
demographic differentiation in quality of
life among the prehistoric Moche people
of the Peruvian north coast. The vertebral
elements from skeletons excavated at San
Jose de Moro (N=67) (see Appendices I
and II), a ceremonial cemetery site in the
Jequetepeque Valley, were examined for
degenerative changes of spinal joints (i.e.
zygapophyseal facets and vertebral
bodies). The sample under study
comprises of 48% young adults (n=32)
and 52% middle to older adults (n=35),
49% females (n=33) and 51% males
(n=34), and 55% pit tombs (n=37), 36%
boot tombs (n=24) and 9% chamber tombs
(n=6) (Fig. 6.1). The differences between
Figure 6.6. Total sample size in study categorized according to
males and females were explored, as well
age, sex and burial type (i.e. social class).
as between age cohorts and burial contexts
that are indicative of social status. Given the limitations of time and resources, only individuals from
Late Moche were analyzed.
The San Jose de Moro archaeological site is located on the north coast of Peru in the La
Libertad region, just off of the modern Panamericana highway (Fig. 6.2). Excavations here have been
formally conducted since 1991 under the direction of Dr. Luis Jaime Castillo, but the site was well
known before then because of the profitable activities of looters. The site has yielded several
significant contributions to Moche archaeology, most notably the Priestesses of San Jose de Moro,
female burials believed to be the Priestess figure in the Sacrifice Ceremony of Moche iconography
(see Chapter 5).
6.1.1 Time Period
Occupation at San Jose de Moro was continuous from the Middle Moche period up to ChimuInca times, with its densest levels during the Late Moche period, which covered most of the 7th
century AD (Castillo, 2001). Given the limitations of time and resources, analysis focuses on Late
Moche (~AD 700-800) burials. Furthermore, previous archaeological investigations have revealed
that this period characterizes the strongest disparities between the elite ruling class and commoners in
Moche prehistory (Castillo, 2000, 2001; Swenson, 2011), making this occupation level excellent for
the present purposes. Castillo (pers. comm., 2013) has also recommended this focus.
34
Figure 6.2. Map of excavation units at San Jose de Moro, Peru. Colours indicate year of excavation from 1991 to 2012. Inset
(bottom left) shows map of the protected archaeological zone of San Jose de Moro. Map provided by the San Jose de Moro
Archaeological Project.
6.2 Methods
The vertebrae from each individual were examined by vertebra and vertebral region for spinal
degenerative joint disease (SDJD) at the major joints of the spine: zygapophyseal and intervertebral.
Each joint was scored according to the diagnostic criteria below. Individuals were assessed by age
and sex (Buikstra & Ubelaker, 1994), social status, and degree of preservation. Data aggregation
methods are succeeded by a brief description of the statistical methods employed including Chi
square tests in combination with frequency measures.
The null hypothesis that no observable differences in lesion severity exist between ages, sexes
and burial types is tested through comparisons of lesion frequency and severity as well as Chi-square
tests. Given that the manifestation of OA is influenced by several factors, among which are age, sex
and activity, we expect to see that at least some difference may be present.
35
6.2.1 Diagnostic Criteria
Bony lesions indicative of osteoarthritis and degenerative joint disease were examined using
methods derived from those of Sandness and Reinhard (1992), Stirland and Waldron (1997), RojasSepulveda et al. (2008), and Novak and Slaus (2011) (see Chapter 4 for critique of methods
surveyed). Lesions are scored on an ordinal scale from 0 (none), 1 (slight), 2 (moderate), and 3
(severe). Criteria for zygapophyseal facets (Fig. 6.3) and vertebral bodies (6.4) include: marginal
Figure 6.3. Stages recorded for the manifestation of spinal degenerative joint lesions (marginal lipping, ostephytes, eburnation,
surface porosity and new bone growth) of the zygapophyseal facet. Only slight (1) osteophytes and new bone growth were
encountered during the study. Scale bars = 1cm.
36
osteophytosis, changes to the joint contour or lipping, surface porosity or pitting, new bone formation
on the joint surface, eburnation (exclusive to zygapophyseal facets), and Schmorl’s nodes (exclusive
to vertebral bodies).
Figure 6.4. Stages recorded for the manifestation of spinal degenerative joint lesions (marginal lipping, ostephytes, Schmorl’s
nodes, surface porosity and new bone growth) of the vertebral body. Only slight new bone growth was encountered during the
study. Scale bars = 1cm.
37
These criteria are adapted from Waldron’s (2009) operational definition of osteoarthritis and
intervertebral disc disease, where at least two of the first four criteria must be observed, or at least
one of the last two criteria is observed to indicate the presence of OA (Table 6.1).
Operational definition for osteoarthritis
Zygapophyseal Facets
Vertebral Bodies
At least two of
At least two of
Marginal Osteophytosis
Marginal Osteophytosis
Lipping
Lipping
Surface Porosity
Surface Porosity
New Bone Formation
New Bone Formation
OR at least one of
Eburnation
OR at least one of
Schmorl’s Nodes
Table 6.1. Operational definition for osteoarthritis modified from Waldron (2009) according to zygapophyseal facet and vertebral
body.
6.2.2 Points of Observation
All vertebrae were examined. However, the sacrum was excluded because of its involvement
with the pelvic girdle. Each point of observation was scored separately and later aggregated (see
below). Sites of observation are the left and right superior and inferior surfaces of the vertebral body,
and the left and right superior and inferior zygapophyseal facets, including the atlantoaxial joint.
6.2.3 Age and Sex Estimation
The estimation of individual age and sex has already been accomplished, mostly by student
participants of the San Jose de Moro field school. Estimation utilized the methods and guidelines
provided by Buikstra and Ubelaker (1994). These records were reassessed and verified according to
the same methods and guidelines by the author before inclusion in the sample.
Individuals were initially grouped into three age cohorts (Fig. 1). The age categories are
young adult (20-35 years), middle adult (35-50 years), and older adult (50+ years). The limited
number of older adults (n=2) warranted a merger with middle-aged adults. Thus, analyses with
regards to age separate young adults (20-35 years) and middle to older adults (35+ years). Subadults
and individuals with ambiguous or unknown age and sex estimations were excluded from analysis.
6.2.4 Social Status
Social status of each individual was determined from burial context, particularly burial type:
pit tombs, boot-shaped tombs and chamber tombs (Fig. 6.1). Individuals interred in simple pit burials
were designated as lower class (n=37), those interred in boot-shaped tombs were designated as
middle class (n=24), and those interred in adobe chamber tombs were designated as elites (n=6)
(Chapdelaine, 2011). Individuals in elite chamber tombs believed to represent retainers or sacrificial
offerings were excluded from analysis, as their membership in a particular social class cannot be
38
verified. For further details on Moche burial practice, see Chapter 5 on the archaeological context of
San Jose de Moro.
6.2.5 Preservation
Preservation quality of individual vertebral elements was assessed prior to inclusion in the
data set. The vertebral body and neural arch were scored separately. Four codes were employed:
complete (>75% present), incomplete (25-75% present), very incomplete (<25% present), and absent
(not assessable). For the neural arches, completeness were dependent on the presence of right and left
superior and inferior zygapophyseal facets. Severely damaged or lacking vertebral elements, such as
less than 25% of the spine present, barred inclusion of an individual into the data set.
6.2.6 Statistical Methods
For the purposes of manageable statistical analyses, data was collapsed by taking the
maximum score for a given joint type (e.g. the maximum score for all zygapophyseal facets of a C3
vertebra was 2, so a score of 2 was assigned to the zygapophyseal facets of the C3 for that
individual). This data was further collapsed by taking the maximum score among vertebra of a
particular region and joint type as the representative score for that region (e.g. a score of 3 for the
vertebral bodies of the cervical region).
Severity frequencies were also plotted in order to compare categories within variables, such
as males versus females, young adults versus middle to older adults, and pit tombs versus boot tombs
versus chamber tombs (Fig. 7.2-7.7). For the purposes of these frequencies, scores of none and slight
(unpronounced) were aggregated, as well as for scores of moderate and severe (pronounced). In the
case of eburnation, scores of slight, moderate and severe were aggregated as moderate to severe with
the consideration that the presence of eburnation, even if slight, represents the complete destruction
of cartilage and thus is pathognomonic of SDJD (Rothschild, 1997; Weiss & Jurmain, 2007;
Waldron, 2009).
The frequency of absent to slight (0-1) and moderate to severe (2-3) manifestations of spinal
degenerative joint disease for zygapophyseal facets and vertebral bodies were compared between
ages, sexes and burial types (Fig. 7.2-7.7 in Results Chapter). Pearson’s chi-square (χ2) test was used
in order to determine whether or not a statistically significant (P<0.05) relationship exists between
the variables in question. Chi-square was chosen to test the null hypothesis that no statistically
significant differences exist between the different age classes, sexes or burial types. Thus, the
observed count will be equal to the expected count. Any disparity between the observed and expected
counts is then measured by the test and given a value that suggests whether a significant difference
exists between the variables.
39
CHAPTER 7. RESULTS
7.1 Introduction
The articular joints in the spinal column were scored according to the severity of spinal
degenerative joint disease (SDJD). The sample under study here comes from Late Moche skeletons
excavated at San Jose de Moro,
Peru. Results from zygapophyseal
facets are considered separately
from vertebral bodies as these
represent two different joint types:
synovial and symphyseal,
respectively (Fig. 7.1). Visual
juxtapositions of lesion severity in
Figures 7.2 to 7.7 reveal a
Figure 7.1. (a) Anterior view of thoracic neural arch. Superior zygapophyseal facets
majority of differences, although
face posteriorly (white arrows), inferior zygapophyseal facets face anteriorly (black
arrows). (b) Superior view of a lumbar vertebra. Severe pitting and moderate
most statistically insignificant
osteophytes on the vertebral body margins (black arrows). Scale Bar = 1cm.
according to Chi-square testing.
7.2 Zygapophyseal Facets
P value
Age * ZFCa
9.429
0.009
2
b
1.338
0.720
5
c
3.030
0.387
4
Age * ZFT
Age * ZFL
Figure 7.2. Percentage of absent to slight and moderate to severe SDJD in
zygapophyseal facets among young (n=32) and middle to older adults
(n=35).
# of Cells with E<5
Chi-square
value
Relationship
One isolated comparison between young adults and middle to older adults incorporating all
sexes and burial types yielded a significant relationship in the cervical vertebrae (χ2=9.429, P=0.009)
(Fig. 7.2 and Table 7.1). There is a higher prevalence of moderate and severe (pronounced) SDJD in
middle to older adults versus young adults, who have a higher frequency of only slight SDJD
severity (unpronounced). This result must be taken conservatively as 2 cells in the Chi-square
analysis had expected counts less than 5. However, further collapsing of this variable by assigning
scores of 0 and 1 as absent and 2 and 3 as present yielded a stronger difference (χ2=7.839, P=0.005)
with no cells with expected counts less than 5.
Table 7.1. Chi-square values and significance
values for relationships between age and
joint region.
a = zygapophyseal facets of the cervicals
b = zygapophyseal facets of the thoracics
c = zygapophyseal facets of the lumbars
40
Chi-square
value
P value
2.630
4.876
1.490
0.268
0.181
0.685
# of Cells with E<5
Relationship
Sex * ZFC
Sex * ZFT
Sex * ZFL
2
5
4
Table 7.2. Chi-square values and significance
values for relationships between sex and joint
region.
Figure 7.3. Percentage of absent to slight and moderate to severe SDJD in
zygapophyseal facets among males (n=34) and females (n=33).
Pronounced SDJD seems more prevalent in males than in females, particularly in the lumbar
region (χ2=1.490, P=0.685) (Fig. 7.3). The cervical (χ2=2.630, P=0.268) and thoracic (χ2=4.876,
P=0.181) regions are comparably similar, but with a much greater incidence in the atlas of females,
and higher absence in majority of the thoracic and lumbar vertebrae. Chi-square testing does not
show that these observations are statistically significant (Table 7.2).
Although unsupported by Chi-square testing (Table 7.3), visual assessment of severity
frequencies suggest a higher incidence of pronounced SDJD among individuals from pit tombs
(n=37) versus a comparable sample size of boot-shaped tombs (n=24). This is particularly evident in
the cervical (χ2=7.685, P=0.104) and lumbar (χ2=2.513, P=0.867) regions, with a complete lack of
pronounced scores among thoracic vertebrae in boot tombs (χ2=5.235, P=0.514) (Fig. 7.4). Although
the frequency of severe cervical cases in chamber tombs seems comparable to that in pit tombs, it
should be considered that the entire sample size of chamber tomb individuals is much lower (n=6). It
Figure 7.4. Percentage of absent to slight and moderate to severe SDJD in zygapophyseal facets among individuals from pit
(n=37), boot (n=24), and chamber (n=6) tombs.
41
Chi-square
value
P value
7.685
5.235
2.513
0.104
0.514
0.867
# of Cells with E<5
Relationship
Burial Type * ZFC
Burial Type * ZFT
Burial Type * ZFL
is included here for completeness. However, it would seem
among the 6 individuals belonging to chamber tombs, there
is an absence of pronounced manifestations of SDJD in all of
the thoracic vertebrae and majority of the lumbar vertebrae.
5
9
8
Table 7.3. Chi-square values and significance
values for relationships between burial type and
joint region.
7.3 Vertebral Bodies
Chi-square
value
P value
Age * VBCa
Age * VBTb
Age * VBLc
1.899
2.327
2.368
0.594
0.507
0.500
# of Cells with E<5
Relationship
Unlike its zygapophyseal facet counterparts, vertebral body SDJD between young and middle
to older adults show no statistically significant differences in any particular region of the spine
(χ2=1.899, P=0.594 for cervicals; χ2=2.327, P=0.507 for thoracics; χ2=2.368, P=0.500 for lumbars)
(Table 7.4). This is supported to an extent by the juxtaposition of frequencies in Figure 7.5. It would
seem that there is a general decrease of severity at the junctions between spinal regions in both age
cohorts.
4
4
2
Table 7.4. Chi-square values and significance
values for relationships between age and
joint region.
a = vertebral body of the cervicals
b = vertebral body of the thoracics
c = vertebral body of the lumbars
Figure 7.5. Percentage of absent to slight and moderate to severe SDJD in
vertebral bodies among young (n=32) and middle to older adults (n=35).
The visual comparison of severity frequencies among young and middle to older adult
vertebral bodies is similar, with spikes in the mid-cervical, mid-thoracic and lower lumbar regions
(Fig. 7.6). Vertebral bodies between sexes and pit and boot tombs show a similar pattern (Fig. 7.7).
This pattern is also true for age, sex and burial type in the mid-cervical regions of the zygapophyseal
facets, but additional spikes manifest in the lower thoracic and lumbar.
42
Chi-square
value
P value
Sex * VBC
Sex * VBT
Sex * VBL
1.240
1.959
0.741
0.744
0.581
0.864
# of Cells with E<5
Relationship
There are no statistically significant differences in the vertebral bodies according to sex
(Table 7.5). However, visual juxtaposition suggests unpronounced thoracic and upper lumbar SDJD
in females versus more pronounced SDJD in males from the lower thoracics downward (Fig. 7.6).
Cervical SDJD between males and females seems comparable, but with an elevated severity in the
C1 of females (Fig. 7.6).
4
4
2
Table 7.5. Chi-square values and significance
values for relationships between sex and joint
region.
Figure 7.6. Percentage of absent to slight and moderate to severe SDJD in
vertebral bodies among males (n=34) and females (n=33).
Contrary to observations among zygapophyseal facets (Fig. 7.4), vertebral bodies from pit
and boot tombs display very similar frequencies (Fig. 7.7). Indeed these are supported by a lack of
any significant difference using Chi-square analysis (Table 7.6). Both burial contexts present a
pattern of increasing severity frequency at the mid-cervical, mid-thoracic and lower lumbar regions,
much like the pattern observed between sexes (Fig. 7.6). Chamber tombs cannot be compared with
other burial contexts because of the limited sample size (n=6). However, a consistent frequency of
severity is seen across the lower cervicals through to the thoracics and lumbars. This is in sharp
Figure 7.7. Percentage of absent to slight and moderate to severe SDJD in vertebral bodies among individuals from pit
(n=37), boot (n=24), and chamber (n=6) tombs.
43
Chi-square
value
P value
Burial Type * VBC
Burial Type * VBT
Burial Type * VBL
6.165
4.409
7.098
0.405
0.622
0.312
# of Cells with E<5
Relationship
contrast to the complete absence of severe lesions in
thoracic zygapophyseal facets and almost complete absence
in lumbar zygapophyseal facets, based on visual inspection
alone (Fig. 7.4).
9
8
7
Table 7.6. Chi-square values and significance
values for relationships between burial type and
joint region.
7.4 Summary
All except one of the results show statistical insignificance according to Chi-square testing,
(summarized in Table 7.7), but may still be intuitively valuable using visual juxtaposition by
providing avenues for interpretation in the absence of significant relationships. Indeed, some visual
differences are striking, yet are not reflected through the statistics (e.g. the difference in pronounced
SDJD between pit and boot tomb cervical zygapophyseal facets, χ2=7.685, P=0.104, Fig. 7.4).
Despite a lack of statistically significant results, the distribution of lesion frequencies throughout the
spine may still be telling, even if only slightly, of differentiation between age cohorts, sexes and
social classes. Increased age is an important factor for increased severity of SDJD lesions. There are
observable differences between males and females, although insignificant, with some regions being
more affected than others in both sexes. Social status also plays an important role in the acquisition
of degenerative spinal changes, with the lower class manifesting greater frequencies of moderate to
severe lesions than their higher ranking counterparts. In summary, differences in the quality of life
and activity possibly exist among the Late Moche occupants of San Jose de Moro in terms of age
cohorts, sexes and social classes, but a refinement of this research using the avenue of SDJD and
others is strongly recommended.
Relationship
Age * ZFC
Age * ZFT
Age * ZFL
Sex * ZFC
Sex * ZFT
Sex * ZFL
Burial Type * ZFC
Burial Type * ZFT
Burial Type * ZFL
Age * VBC
Age * VBT
Age * VBL
Sex * VBC
Sex * VBT
Sex * VBL
Burial Type * VBC
Burial Type * VBT
Burial Type * VBL
Chi-square value
9.429
1.338
3.030
2.630
4.876
1.490
7.685
5.235
2.513
1.899
2.327
2.368
1.240
1.959
0.741
6.165
4.409
7.098
P value
0.009
0.720
0.387
0.268
0.181
0.685
0.104
0.514
0.867
0.594
0.507
0.500
0.744
0.581
0.864
0.405
0.622
0.312
# of Cells with E<5
2
5
4
2
5
4
5
9
8
4
4
2
4
4
2
9
8
7
Table 7.7. Summary of Chi-square and significance value results comparing multiple variables with joint regions.
44
CHAPTER 8. DISCUSSION
8.1 Introduction
The site of San Jose de Moro (SJM) represents continuous occupation from the Middle
Moche period up to Chimu-Inca times. However, this study is focused on the Late Moche period
(AD 700-800), as it represents the greatest degree of social unrest (Swenson, 2007) and rigid social
inequality (Swenson, 2011) that culminated in final collapse (Castillo, 2001) among the Moche
periods. Furthermore, it is the densest and most well-represented occupation at the site. If such a
stratified social system exists, we can expect to see differences in the frequencies of OA severity
between different groups. This hypothesis has been supported by the results just presented in the
previous chapter, and further explain in this chapter.
Each age cohort presents comparable sample sizes with 32 young adults and 35 middle and
older adults. Both sexes are also relatively even in their distribution with 33 females and 34 males. In
terms of burial type and social status, commoners from pit tombs and the middle class from bootshaped tombs are relatively similar with 37 and 24 individuals, respectively. Unfortunately, because
of the rarity of elites (n=6), meaningful juxtapositions with these individuals may be dubious.
Furthermore, only cervical zygapophyseal facets between age cohorts yielded statistically significant
results, while all other comparisons were statistically insignificant, possibly in part as a factor of
sample size. These factors make the skeletal collection at SJM a challenging assemblage for the
study of demographic differentiation through spinal degenerative joint disease (SDJD) in terms of
age, sex and social status (elites excepted).
San Jose de Moro is positioned along one of the secondary irrigation arteries of the main
drainage of the Jequetepeque River. This irrigation canal was established in ancient times during the
much later northern expansion of the valley. Despite the prevailing idea that different Moche polities
were constantly at odds with each other (Swenson, 2007, 2011) SJM served as a communal
ceremonial centre for all occupants of the valley to bury and celebrate their dead (Millaire, 2002,
2004; Castillo, 2010b). Material culture from the site suggests that producing fine ceramic wares and
brewing copious amounts of chicha or maize beer were regular activities (Castillo, 2001, 2010),
products involved in feastings and festivities during mortuary practices (Swenson, 2007). It would
seem that the individuals at San Jose de Moro originated from both local and provincial communities
throughout the Jequetepeque despite episodes of contention.
Both past and recent literature on Moche archaeology has been centered on cultural
adaptation, urbanism, iconography, craft production and specialization, and trade (see Quilter, 2002;
Chapdelaine, 2011). Scarce information has been published on the exploration of Moche daily life.
The lack of this emphasis in their art and mortuary practices is partly to blame, and indeed when
daily life is illustrated it is done so to express religious or ritualistic concepts rather than to
demonstrate everyday acts (Quilter, 2002). This marks an opportunity for the current data to
contribute to knowledge about the dissimilarity in the quality of life experienced by different sectors
of the community. To date, no other formal study has focused on the Late Moche of San Jose de
Moro through the use of skeletal material.
45
8.2 Age
Clinical literature advocates that increasing age is highly correlated with SDJD severity
(Anderson & Loeser, 2010; Loeser, 2011). The statistically significant (χ2=9.429, P=0.009) increased
presence of moderate and severe cervical zygapophyseal SDJD among middle and older adults in
comparison to young adults supports this. However, the relatively comparable thoracic and lumbar
severities between the two age groups questions whether individuals undergo severe stresses early in
adult life and reduce physical activity once reaching middle age, as we should expect aggravated
lesions throughout the spine as age progresses (Prescher, 1998). This would explain a plateau in the
acquisition of more severe lesions among middle and older adults. Lovell (1994) found similar
results while working on Harappan skeletons from the Indus Valley, and attributes severe cervical
joint changes to accumulated microtrauma from physical stress, as opposed to normal age and sex
predispositions. Furthermore, the increased severity in the cervical spine among middle to older
Moche adults may indicate a shift in activities from more laborious load-bearing tasks involving the
mid and lower back to activities primarily involving the neck. Because SDJD and other osteoarthritic
changes are accumulated throughout life a shift in activities may retard the accumulation at the mid
and lower back region and increase accumulation at the neck. Currently, the lack of iconographic
representation of everyday life hinders any valid claims to changing activities with age. These
assertions will remain speculative until or if such time that more telling evidence is excavated.
Jurmain and Kilgore (1995) caution that rather than attribute observed degenerative changes to
specific activities, it is more valid to restrict analysis to the range of motions inherent to the particular
region of the spine. The cervical region allows a greater range of motions versus the thoracic or
lumbar spine including flexion, extension, lateral flexion, and rotation. The region is more subject to
damage from mechanical loading, as its greater mobility grants more opportunities for compressive
and tensile forces from multiple directions (Platzer, 2004). The thoracic region is mainly responsible
for rotational movements, and the lumbar vertebrae allow flexion, extension and lateral flexion.
Occupational stresses that involve
bending, kneeling and stooping over
increase the risk of developing
osteoarthritis (Busija et al., 2010). These
movements involve prolonged flexed
postures and punctuated extended postures
of the body trunk.
Because of the angled
zygapophyseal joints and concave unciate
joints of the cervical vertebrae, a whole
range of motions are available to the neck.
Ethnographic evidence, such as the
position demonstrated in Figure 8.1,
provides an analogy for how prehistoric
Moche artisans might have gone about
constructing their crafts. Stirland and
Waldron (1997) suggest accelerated
degenerative changes in the cervical spine
from the neck being permanently hunched
Figure 8.1. Local San Jose de Moro ceramicist Julio Ibarrola Quiroz
replicates ceramic vessels excavated at the site. Notice the stooped
position of the neck. Ancient Moche artisans would have likely been in
similar positions for prolonged periods of time. Photo provided by the
San Jose de More Archaeological Project.
46
forward or to the side in a stooped position (Fig. 8.1). This causes the cervical neck to flex downward
(extending the longissimus capitis, splenius capitis, longissimus cervicis, splenius cervicis and
semispinalis cervicis attached posteriorly) or sideward (extending the scalene muscles attached
laterally). Degenerative changes can also be brought about by habitual burdens to the neck (Hukuda
et al., 2000). In order to meaningfully interpret these cervical changes, they must be evaluated in
terms of occupational stress. Occupation may be determined from burial contexts (and associated
social status), discussed below.
8.3 Sex
If we assume that the determined sexes of individuals are indicative of gender status in the
society, then meaningful interpretations can be made regarding gender roles at SJM. However, sexual
dimorphism in muscle and bone mass must be taken into consideration, as well as changing gender
roles among different social classes. In this sample, there is a greater proportion of males with
pronounced SDJD in lower thoracic and lumbar facets (χ2=1.490, P=0.685 for lumbars; Fig. 7.3).
However, no evident pattern appears between vertebral bodies according to sex. Both males and
females have visually similar severities of cervical SDJD (Fig. 7.3 and Fig. 7.6), with slightly higher
cervical facet SDJD among females (χ2=2.630, P=0.268), particularly in the atlas. From mortuary
archaeological data, Moche archaeologists suggest differentiation in activities among males and
females (Verano, 2000; Chapdelaine, 2011; Chicoine, 2011), as will be discussed here. The visual
differences in SDJD severity observed here, although statistically unsupported, are evaluated in light
of the archaeological evidence in an attempt to explain these differences.
Looking for the presence of gender differentiation in the related archaeological record of the
region, an oral health assessment of Salinar and Gallinazo skeletons (400 BC-AD 200), predecessors
of the Moche in the Moche Valley, revealed a greater abundance of dental caries among females
(Gagnon & Wiesen, 2013). This occurs at the onset of agriculture among the Salinar and Gallinazo in
the north coast of Peru, where more carbohydrate-rich foods such as maize were introduced into the
diet (Lambert et al., 2012). The authors also attribute this abundance of caries to pregnancy, whereby
salivary changes during pregnancy predisposed the development of caries (Gagnon & Wiesen, 2013).
Males on the other hand shift to tougher, higher protein foods such as meat and marine resources as
evidenced by increased in tooth wear over time and relatively stable frequency of caries (Gagnon &
Wiesen, 2013). The Osteological Paradox may be at work here since males may have been at a
higher nutritional advantage due to their proteinaceous diet than women, and so developed less
caries. Ultimately, this finding indicates that sex-specific patterns in oral health already existed in the
same region much earlier than the first Moche cities, and perhaps speculatively such gender activity
differentiation involved spinal health as well.
In males, activities involving the building and maintenance of agricultural fields, monumental
architecture and irrigation canals (Swenson, 2003, 2007; Chapdelaine, 2011) necessitated habitual
lifting of heavy loads. An Early Intermediate Period (100 BC-AD 100) study on the central coast of
Peru in the Lurin Valley demonstrated unequal distribution of labor in this sample, with males having
more advanced degenerative joint disease (Pechenkina & Delgado, 2006). Also, warfare remains as
one of the key features of Moche culture. This is strongly evidenced in their iconography (Quilter,
2002; Sutter & Cortez, 2005; Sutter & Verano, 2007; Swenson, 2011) and the intrusive signature of
47
Moche conquests in the archaeological sequence (Quilter, 2002; Sutter & Cortez, 2005). Weapons
are also highly correlated with male burials (Chicoine, 2011). Large armies would have been
required for expansion campaigns, and were almost surely solely comprised of men. The
iconographic depiction of naked-bound captured soldiers from several fineline paintings are all male
(Fig. 8.2). Moreover, Verano’s (2000) analyses of over 60 sacrificial victims at Huaca de la Luna,
presumably captured soldiers from losing armies, were all males from the ages of 15 to 39. The
preparation for and participation in war likely involved episodes of severe, acute stress, as evidenced
by the numerous antemortem and perimortem fractures present (Verano, 2000).
Figure 8.2. Fineline drawing of naked-bound prisoners in procession with (upper right) one having his throat slit, and
(below) dead aprisoners and a severred head. Notice the presence of male genetalia on all the prisoners. Drawing by Donna
McClelland. Taken from Sutter and Cortez, 2005.
In females, cervical severity suggests activities involving load bearing of the neck or habitual
stooped positions (Stirland & Waldron, 1997; Hukuda et al., 2000). Ethnographic work done among
contemporary rural Mesoamerican communities demonstrates that textile production is a full-time
endeavor among women (Hendon, 2006). Archaeologically, Costin (2008) attributes textile
production as a largely female endeavor in the Prehispanic Andes, although with some minimal male
involvement. In Moche contexts, spindle whorls involved in the production of yarn (Chapdelaine et
al., 2001) are found in high association with female burials (Chicoine, 2011). Molleson (2007)
describes a female burial from al-‘Ubaid, Iraq where a large spindle whorl and stone pounder were
interred with the deceased. The spine of this skeleton showed significantly enlarge lower thoracic
vertebrae, narrowed lumbars, and cleft first and second sacral elements. Although dissimilar in many
ways, the burial from al-‘Ubaid and the women from SJM may have both weaved impressive textiles
in stationary positions (Fig. 8.3). Investigators in other parts of the world have found that cervical
SDJD can be a result from carrying loads on top of the head, which puts significant strain on the neck
(Bridges, 1994; Lovell, 1994). This is further supported by clinical data (Jager et al., 1997). It is
unclear whether Moche women actually practiced such a method since pack animals such as
camelids were available, but it nevertheless remains a possibility. The activity is certainly practiced
today worldwide among some indigenous cultures, particularly in Africa (Willems et al., 2006;
Lloyd et al., 2010; Beaucage-Gauvreau et al., 2011; Porter et al., 2013).
48
The mortuary context of the site
supports the idea of a ruling female elite.
This is famously evidenced by the
Priestesses of San Jose de Moro, women
who possessed the most elaborately
decorated chamber tombs and held the
highest positions of SJM society (Donnan
and Castillo, 1992; Castillo, 2010b).
Perhaps at SJM, women even across lower
and middle social statuses held more
influence than men, and thus did not share
in the physical burdens of monumental
building and large scale farming as men
did. This is supported by the decreased
presence of moderate to severe lesions in
female zygapophyseal facets and vertebral
bodies than what is observed in males
(Figs. 7.3 and 7.6). However, this
phenomenon may not be entirely
applicable to neighboring Moche polities.
The presence of male leaders in analogous
positions of power such as the Lords of
Sipan (Alva, 2001) demonstrate that the
occupation of women in the highest ranks
of society was not universal across the
north coast. In addition, European
ethnographic sources have painted the
perception of weaving and textile working
Figure 8.3. Modern Andean women weaving textiles with traditional
as an exclusively female task, but
techniques using a backstrap loom. Notice that tension is applied to
th
accounts from 18 century drawings of
the fabric using the lower back to pull back the entire contraption (top
the north coast of Peru depict women
photo). Taken from Virtual Tourist, www.virtualtourist.com.
Preserved Moche textile on humeral shaft used to wrap body during
actively caring for livestock and tending
interment (bottom photo). Photograph author’s own.
agricultural fields (Klaus et al., 2009).
However, Rojas-Sepulveda and colleagues
(2008) in their research of a pre-Columbian Muisca series from Colombia dated three centuries after
the disappearance of the Moche found no gender differences in their sample based on SDJD criteria.
It would seem both males and females from this nearby culture equally shared in the agricultural
work, contradicting the findings of Pechenkina and Delgado (2006) in the Lurin Valley. From the
osteological evidence presented here, it would seem to support the latter, with more pronounced
lesions in the lower back among males of SJM.
49
8.4 Social Status
Differing social statuses imply a division of labor and activities, as supported by varying
material culture interred with different burial types (Quilter, 2002; Chapdelaine, 2011). Differing
activities would then possibly be reflected in varied patterns of OA affliction. The discussion of
social class is limited to commoners from pit tombs (n=37) and the middle class from boot-shaped
tombs (n=24) because of the small sample size of elites from chamber tombs (n=6). These two
groups possess comparable sample sizes in contrast to chamber tombs. However, intersample
comparisons among elites in this collection may be more useful rather than intrasample discussions.
Interestingly, Gagnon’s (2008) analysis of the “proto-Moche” or Gallinazo culture (400 BCAD 200) dental health reveals status was not important at the time for the acquisition of quality
foods, but it was sex that played a more significant role in this respect. She however argues that “by
expanding existing gender differences, Moche elites created the social hierarchies that come to
characterize the state” (Gagnon, 2008: 173). Further forward in time, the transition from the Middle
Moche to Late Moche periods saw a shift in obedience to funerary norms in pit tombs and thus by
extension the lower class (Donley, 2008). Unfortunately, no similar study as of this writing has been
produced for the middle class burials. The Late Moche commoners were interred in ways that
ignored prevailing burial customs of previous generations. Firstly, significant increases in the sheer
number of pit tombs occurs from the Middle to Late Moche. Secondly, infants and only a few adults
were interred in pit tombs during the Middle Moche, while Late Moche pit tombs represent all ages
(Donley, 2008). Thirdly, body orientation changes from heads towards the south or east in Middle
Moche to no specific direction during the Late Moche. Fourthly, where any sort of metal object was
usually interred with pit tombs from the Middle Moche, metal objects become rare in Late Moche pit
tombs. Whether this was in defiance of the elites by commoners, a decline in the importance of such
beliefs by commoners, or exclusion of commoners by elites in their ideological systems, it implies
the transition marked a widening chasm between the social classes (Donley, 2008).The differences
between commoners and the middle class are most notable through zygapophyseal facets rather than
vertebral bodies. A greater incidence of pronounced OA lesions is present among the pit tomb
cervical regions (χ2=7.685, P=0.104). Commoners, who were involved with the more physically
laborious tasks of society,
have more severe arthritic
lesions throughout all
regions of the spine (Fig.
7.4). These activities
would have almost
certainly involved the
tending and preparing of
agricultural fields,
maintaining irrigation
canals, making mud bricks
and the building of
monumental architecture
commissioned by the local
Figure 8.4. Various Moche ceramic vessels chronologically arranged from Southern Moche
(Swenson, 2003, 2007;
Phase I to V (left to right) on permanent display at the Larco Museum, Lima, Peru.
Chapdelaine, 2011). This
50
would have contributed significant strain on the load-bearing joints of the spine, and would have
been conducive for the development of pronounced SDJD. Modern studies have shown a positive
association between the development of musculoskeletal disorders and labor-intensive agriculture
(Walker-Bone & Palmer, 2002; Fathallah, 2010) and manual labour (Holte et al., 2000; Punnett &
Wegman, 2004). In particular, cervical changes may be explained by carrying loads on head
(Bridges, 1994; Lovell, 1994) or stooping the neck downwards for prolonged, redundant periods
(Stirland & Waldron, 1997; Hukuda et al., 2000). Thoracic changes may be related to mechanical
movements of the arms and back (Ustundag, 2009). Lumbar changes are almost certainly a reflection
of general increased load bearing of the entire upper body (Niosi & Oxland, 2004). Degenerative
secondary OA also originates from incidences of trauma (Waldron, 2009), incidences to which
commoners in their active lifestyles would have been more prone.
Pronounced lesions among the middle
class are primarily isolated to the cervical and
lumbar regions. The middle class comprised
mostly of craftsmen whose works sought to
serve the desires of the elite (Makowski, 2008;
Bernier, 2010). The production of elaborate
ceramic vessels and metal objects (Fig. 8.4),
which would have taken large investments of
time, necessitated meticulous care and possibly
stooped positions (Fig. 8.1). Excavations of
workshops suggest these craftsmen were totally
dedicated to their craft with little to no
involvement in the activities of builders and
farmers (Bernier, 2010). Craftsmen likely
Figure 8.5. A woman kneading or “wedging” raw clay in
utilized muscle groups of the upper torso, while
preparation for crafting it into a ceramic vessel. Photo taken from
labourers would have likely used the whole
Daily Art Muse, www.dailyartmuse.com
range of their back muscles. Such a scenario
could explain the presence of cervical SDJD among individuals from boot-shaped tombs, but at a
severity much less than those of skeletons interred in lower class pit tombs. This then leaves us to
question why this pattern is also apparent in middle class lumbar vertebrae. They were likely
preparing and kneading their own clay for ceramic vessels, which would produce considerable lower
back strain (Fig. 8.5), similar to lower lumbar degenerative disease in an Abu-Hureyra skeleton
linked to grinding grain while kneeled on the floor (Molleson, 1994). If we follow the warnings of
Jurmain and Kilgore (1995) then the most valid of our assumptions of prehistoric activity are
restricted to inferring only the movements involved. As such, middle class craftsmen likely were
involved in activities of axial loading. This could range from the handling of their raw materials (e.g.
preparing clay by continuously kneading it), but unlikely assisted commoners in their agricultural
and constructional duties. At this point, further research is warranted.
Isolating interpretations solely to individuals recovered from chamber tombs, it would seem
the cervical spine is the most affected region, followed by the thoracic and lumbar vertebral bodies.
Zygapophyseal facets of the thoracic spine in elites show a complete absence of any moderate or
severe lesions and only minimally occur in the lumbar region. The elite served as the political and
religious leaders of the community (Chapdelaine, 2011). Thus, their activities would seem to be
51
primarily administrative and religious. The
observed frequencies of moderate to severe
lesions may be a reflection of wearing
elaborately large headdresses and facial regalia
(Fig. 8.6), material culture that has frequently
been encountered in royal tombs and signify
high rank (Verano et al., 2000). These would be
worn during public appearances and ritual
rights, but unlikely for prolonged periods.
Nonetheless, interpretations of elite activity
from OA lesions are highly disputable here
considering the small sample size. Furthermore,
the presence of chamber tomb SDJD may just as
likely be a normal function of age, sex, and
genetic factors. Indeed, any interpretation made
with the available data is weak.
8.5 Summary
Figure 8.6. Moche headdresses made of gilded copper on
permanent display at the Larco Museum, Lima, Peru. These
adornments, and others like it, have been found in the tombs
of high ranking individuals from various sites.
Although interpretations of human skeletal material can be extremely useful in informing us
of the past, it is not always clear cut. The materials, results and discussion of this study are made in
the framework of both available skeletal samples and available archaeological contexts, which are
constantly being updated and revised. Uncertainty remains a limiting factor. However, this endeavor
is still worthwhile given that relatively few studies have sought to view the Moche of San Jose de
Moro away from the traditional foci of the elites and their grand projects. From what has been
reviewed above, we can infer a difference in the qualities of life among age groups, sexes and social
statuses, although statistically unsupported here. In general, young adults possess similar lesion
severities to middle to older adults, but with significantly less lesions in the cervical region.
Moreover, interpretations from burial material culture suggest men were more involved in physically
intense activities (e.g. construction, combat), while women concentrated with more stationary chores
(e.g. textile production). Data from spinal health may reflect this, with more pronounced lumbar
severity among men (Figs. 7.3 and 7.5). Finally, commoners were experiencing more physically
taxing lives than their higher ranking counterparts. All except one of these conclusions are
unsupported by Chi-square testing, but are reflected in visual juxtaposition (i.e. bar graphs in Chapter
7) of lesion severity frequencies (e.g. lumbar severities between males and females in Figure 7.3).
The results of this research have unsatisfactorily tackled the hypothesis that differences in OA
lesion severity should occur in the SJM assemblage between different demographic sectors due to a
stratified social system. It remains unclear to what extent differentiation between ages, sexes, and
social classes had on the quality of life among the Late Moche inhabitants of SJM, as reflected in
spinal health. This line of inquiry still remains open for more refined investigations.
Although the conclusions of this study are far from definite, they provide an avenue for future
exploration of Moche daily life, and contribute to the growing discipline of Mochicology. In pursuit
of a clearer picture of Moche demographic differentiation, several future directions are suggested.
52
CHAPTER 9. FUTURE DIRECTIONS
The results of this research have provided valuable insight into the supporting osteological
evidence for a stratified Moche society at San Jose de Moro. Albeit a general lack of statistically
significant differences, visual inspection of different degenerative patterns have been identified
between age cohorts, sexes and social classes throughout the various regions of the spine. Although
these comparisons are not supported by the statistical methods employed here, the results point
toward a promising line of inquiry that can be further explored in order to enhance the archaeological
record of the north coast of Peru. However, as with all archaeological investigations, there is always
room for improvement. These include considerations involving sample size, standardization, multiple
indicator approaches, and inter-site comparisons.
Firstly, sample size limitation is an obvious issue. The skeletal sample used here consists of
67 skeletons of varying ages, sexes and burial types. All of the Chi-square analyses were conducted
with at least 2 cells with expected counts less than 5. This can be resolved through the addition of
more individuals into the working sample. Since excavations at San Jose de Moro are ongoing, this
remains a viable direction.
Secondly, standardization between different studies of OA identification is lacking. Several
authors employ their own methodologies in both the diagnostic criteria used and the scale at which
they are scored (compare Bridges 1992, 1994; Lovell, 1994; Maat et al., 1995; Stirland & Waldron,
1997; Hukuda et al., 2000; Rojas-Sepulveda et al., 2008; Dar et al., 2009; Novak & Slaus, 2011).
Furthermore, because assessment of lesion severity is often conducted on visual terms on an ordinal
scale the potential introduction of biases between observers is high. Indeed, no two skeletal
populations are alike, and a severe manifestation in one may be only moderate in the other. This can
be partly remedied through the inclusion of a series of images of increasing lesion severity for the
sample in question (Fig. 6.3 and 6.4). This then gives other osteologists a basis to compare between
their findings with others. Surprisingly, this is not done as often as it could be.
Thirdly, the focus of this investigation isolated the spinal column as an indicator of the
quality of life these ancient peoples endured. Several other elements of the human skeleton may be
just as telling and, in keeping with the literature of a multifactorial approach, is needed before more
confident statements can be made (Wright & Yoder, 2003). Furthermore, these said additional
indicators must be evaluated under the light of the Osteological Paradox in order to appropriately test
its utility in discerning past health and quality of life (Wood et al., 1992) The oral cavity, for
example, is particularly useful in reconstructing health, past diet and subsistence strategies (Hillson,
2000). Moreover, while this study was limited to adult skeletal remains, an investigation of subadult
health across the different demographic sectors (minus sex) can provide an even clearer image of
social stratification.
Fourthly, the venture of an inter-site investigation including Moche sites beyond the
Jequetepeque Valley may be worthwhile in order to know whether the same social structures present
at SJM emanated in other polities. Although not definite, it would seem the Northern and Southern
Moche spheres were distinct political structures, but united by a common belief system. An inter-site
exploration can yield meaningful interpretations of how much of this belief was shared.
53
The Moche of the north coast of Peru are suggested to be highly stratified, as evidenced by
their material culture and cultural practices (Quilter, 2002; Chapdelaine, 2011). The osteological
material presented in this thesis can possibly be viewed as consistent with this interpretation.
However, given the limited results of this study, conservative interpretations should be made in lieu
of more evidence. The archaeological record of the north coast has the habit of producing quantities
of materials too abundant for even a handful of archaeologists to tackle. By exploring otherwise
untapped sources of information, future data may potentially reaffirm or refute the current
understanding of this powerful desert civilization.
54
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64
APPENDIX I: ZYGAPOPHYSEAL FACET SCORES
Number
M-U 0311
M-U 0405
M-U 0509-1
M-U 0512
M-U 0601
M-U 0620-1
M-U 0620-2
M-U 0620-3
M-U 0622-2
M-U 0626-3
M-U 0710
M-U 0720
M-U 0731
M-U 0734
M-U 0743
M-U 0808
M-U 0817
M-U 0820
M-U 0902
M-U 0920
M-U 1012
M-U 1013
M-U 1022-1
M-U 1027
M-U 1030
M-U 1032
M-U 1044-1
M-U 1044-2
M-U 1047
M-U 1051
M-U 1060
M-U 1121
M-U 1233
M-U 1504
M-U 1505
M-U 1517
M-U 1521
M-U 1522-1
M-U 1525-1
M-U 1525-2
M-U 1536
M-U 1603-A
Age
Young Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Middle Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Young Adult
Sex
Male
Female
Female
Male
Male
Female
Male
Male
Female
Male
Female
Male
Female
Male
Male
Male
Male
Male
Male
Male
Female
Male
Female
Male
Female
Male
Female
Female
Male
Male
Female
Female
Male
Male
Male
Female
Female
Female
Female
Female
Female
Male
Type
Boot
Boot
Pit
Pit
Boot
Pit
Boot
Pit
Boot
Boot
Pit
Pit
Pit
Pit
Pit
Pit
Pit
Boot
Pit
Pit
Pit
Pit
Chamber
Boot
Pit
Pit
Boot
Boot
Boot
Pit
Boot
Pit
Pit
Pit
Pit
Pit
Pit
Pit
Chamber
Chamber
Boot
Pit
Period
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
CERVICAL
1
1
2
1
1
1
3
1
1
3
1
1
1
2
2
2
1
3
1
1
2
1
2
2
2
1
2
1
2
2
1
1
1
2
1
3
1
1
THORACIC
0
1
1
1
1
1
1
1
1
1
2
1
1
1
1
2
1
1
3
1
1
1
1
1
1
2
1
1
1
1
1
1
1
2
1
1
1
1
1
1
1
2
LUMBAR
1
1
1
1
1
1
2
1
1
2
2
1
0
2
1
2
2
1
1
3
2
1
2
2
2
2
3
1
3
1
2
2
1
2
1
1
1
2
1
1
65
Number
M-U 1609
M-U 1710
M-U 1714
M-U 1720
M-U 1726
M-U 1727B-1
M-U 1733
M-U 1740
M-U 1743
M-U 1745-1
M-U 1746-1
M-U 1812
M-U 1814-1
M-U 1814-2
M-U 1814-4
M-U 1913
M-U 1919-1
M-U 1928
M-U 1929
M-U 2003
M-U 2007
M-U 2012-2
M-U 2020
M-U 2101-1
M-U 2107-1
Age
Middle Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Middle Adult
Sex
Female
Male
Male
Female
Female
Male
Female
Male
Female
Male
Male
Female
Male
Male
Female
Male
Female
Male
Male
Female
Female
Female
Female
Female
Female
Type
Pit
Pit
Pit
Pit
Pit
Chamber
Pit
Pit
Boot
Boot
Boot
Chamber
Boot
Boot
Boot
Pit
Boot
Boot
Boot
Pit
Pit
Chamber
Boot
Pit
Boot
Period
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
CERVICAL
2
2
2
2
2
1
2
1
1
1
3
1
1
1
3
2
3
3
1
2
1
1
2
1
THORACIC
1
1
2
1
1
1
1
1
1
1
3
1
1
2
2
3
1
1
2
2
1
1
1
LUMBAR
2
3
2
1
2
1
1
1
2
1
2
1
2
3
3
2
3
2
1
2
2
1
2
2
66
APPENDIX II: VERTEBRAL BODY SCORES
Number
M-U 0311
M-U 0405
M-U 0509-1
M-U 0512
M-U 0601
M-U 0620-1
M-U 0620-2
M-U 0620-3
M-U 0622-2
M-U 0626-3
M-U 0710
M-U 0720
M-U 0731
M-U 0734
M-U 0743
M-U 0808
M-U 0817
M-U 0820
M-U 0902
M-U 0920
M-U 1012
M-U 1013
M-U 1022-1
M-U 1027
M-U 1030
M-U 1032
M-U 1044-1
M-U 1044-2
M-U 1047
M-U 1051
M-U 1060
M-U 1121
M-U 1233
M-U 1504
M-U 1505
M-U 1517
M-U 1521
M-U 1522-1
M-U 1525-1
M-U 1525-2
M-U 1536
M-U 1603-A
Age
Young Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Middle Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Young Adult
Sex
Male
Female
Female
Male
Male
Female
Male
Male
Female
Male
Female
Male
Female
Male
Male
Male
Male
Male
Male
Male
Female
Male
Female
Male
Female
Male
Female
Female
Male
Male
Female
Female
Male
Male
Male
Female
Female
Female
Female
Female
Female
Male
Type
Boot
Boot
Pit
Pit
Boot
Pit
Boot
Pit
Boot
Boot
Pit
Pit
Pit
Pit
Pit
Pit
Pit
Boot
Pit
Pit
Pit
Pit
Chamber
Boot
Pit
Pit
Boot
Boot
Boot
Pit
Boot
Pit
Pit
Pit
Pit
Pit
Pit
Pit
Chamber
Chamber
Boot
Pit
Period
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
CERVICAL
THORACIC
LUMBAR
1
1
3
0
3
1
3
1
0
1
2
1
2
0
1
1
1
0
2
1
1
2
2
2
2
1
3
1
3
1
1
2
1
1
1
1
1
1
1
1
1
2
3
1
1
1
2
2
1
2
0
1
2
0
2
0
1
2
1
1
1
2
1
1
1
2
1
0
2
1
2
2
1
1
1
1
2
2
1
1
2
1
0
1
1
3
1
1
0
1
1
3
1
0
1
1
2
1
2
1
2
2
1
3
2
2
0
1
2
2
1
1
3
3
2
1
1
2
2
1
2
67
Number
M-U 1609
M-U 1710
M-U 1714
M-U 1720
M-U 1726
M-U 1727B-1
M-U 1733
M-U 1740
M-U 1743
M-U 1745-1
M-U 1746-1
M-U 1812
M-U 1814-1
M-U 1814-2
M-U 1814-4
M-U 1913
M-U 1919-1
M-U 1928
M-U 1929
M-U 2003
M-U 2007
M-U 2012-2
M-U 2020
M-U 2101-1
M-U 2107-1
Age
Middle Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Middle Adult
Sex
Female
Male
Male
Female
Female
Male
Female
Male
Female
Male
Male
Female
Male
Male
Female
Male
Female
Male
Male
Female
Female
Female
Female
Female
Female
Type
Pit
Pit
Pit
Pit
Pit
Chamber
Pit
Pit
Boot
Boot
Boot
Chamber
Boot
Boot
Boot
Pit
Boot
Boot
Boot
Pit
Pit
Chamber
Boot
Pit
Boot
Period
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
CERVICAL
THORACIC
LUMBAR
1
1
1
1
0
1
1
1
1
1
2
2
3
2
1
2
2
0
2
1
2
2
3
2
1
3
3
2
1
3
1
2
2
2
1
1
3
3
1
2
1
2
2
1
2
1
2
2
2
2
3
3
1
3
3
1
2
2
3
2
3
1
1
2
1
1
0
1
1
1
1
2
1
68
APPENDIX III: SKELETAL SAMPLE INDIVIDUALS
Number
M-U 0311
M-U 0405
M-U 0509-1
M-U 0512
M-U 0601
M-U 0620-1
M-U 0620-2
M-U 0620-3
M-U 0622-2
M-U 0626-3
M-U 0710
M-U 0720
M-U 0731
M-U 0734
M-U 0743
M-U 0808
M-U 0817
M-U 0820
M-U 0902
M-U 0920
M-U 1012
M-U 1013
M-U 1022-1
M-U 1027
M-U 1030
M-U 1032
M-U 1044-1
M-U 1044-2
M-U 1047
M-U 1051
M-U 1060
M-U 1121
M-U 1233
M-U 1504
M-U 1505
M-U 1517
M-U 1521
M-U 1522-1
M-U 1525-1
M-U 1525-2
M-U 1536
M-U 1603-A
Age
Young Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Middle Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Young Adult
Sex
Male
Female
Female
Male
Male
Female
Male
Male
Female
Male
Female
Male
Female
Male
Male
Male
Male
Male
Male
Male
Female
Male
Female
Male
Female
Male
Female
Female
Male
Male
Female
Female
Male
Male
Male
Female
Female
Female
Female
Female
Female
Male
Type
Boot
Boot
Pit
Pit
Boot
Pit
Boot
Pit
Boot
Boot
Pit
Pit
Pit
Pit
Pit
Pit
Pit
Boot
Pit
Pit
Pit
Pit
Chamber
Boot
Pit
Pit
Boot
Boot
Boot
Pit
Boot
Pit
Pit
Pit
Pit
Pit
Pit
Pit
Chamber
Chamber
Boot
Pit
Period
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
69
Number
M-U 1609
M-U 1710
M-U 1714
M-U 1720
M-U 1726
M-U 1727B-1
M-U 1733
M-U 1740
M-U 1743
M-U 1745-1
M-U 1746-1
M-U 1812
M-U 1814-1
M-U 1814-2
M-U 1814-4
M-U 1913
M-U 1919-1
M-U 1928
M-U 1929
M-U 2003
M-U 2007
M-U 2012-2
M-U 2020
M-U 2101-1
M-U 2107-1
Age
Middle Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Middle Adult
Middle Adult
Young Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Young Adult
Middle Adult
Middle Adult
Middle Adult
Sex
Female
Male
Male
Female
Female
Male
Female
Male
Female
Male
Male
Female
Male
Male
Female
Male
Female
Male
Male
Female
Female
Female
Female
Female
Female
Type
Pit
Pit
Pit
Pit
Pit
Chamber
Pit
Pit
Boot
Boot
Boot
Chamber
Boot
Boot
Boot
Pit
Boot
Boot
Boot
Pit
Pit
Chamber
Boot
Pit
Boot
Period
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
Late Moche
70
APPENDIX IV: DATA RECORDING FORM
Burial Number:
Age:
Sex:
Sup. Z-facet
Right
Inf. Z-facet
Sup. Body
Site:
Context:
Date:
Sup. Z-facet
Feature
Inf. Body
* = Undesignated typical vertebra
Sup. Z-facet = Superior Zygapophyseal Facet
Inf. Z-facet = Inferior Zygapophyseal Facet
Sup. Body = Superior Vertebral Body
Inf. Body = Inferior Vertebral Body
Left
Inf. Z-facet
Sup. Body
0 = None
1 = Slight
2 = Moderate
3 = Severe
(Blank) = N/A
Inf. Body
Preservation:
>75% = Complete
25%-75% = Incomplete
<25% = Very Incomplete
(Blank) = N/A
OP LP PT NB EB OP LP PT NB EB OP LP PT NB SN OP LP PT NB SN OP LP PT NB EB OP LP PT NB EB OP LP PT NB SN OP LP PT NB SN
Legend:
OP = Marginal Osteophytosis
LP = Marginal Lipping
PT = Joint Surface Pitting
NB = New Bone on Joint Surface
EB = Eburnation
SN = Schmorl's Nodes
C1
C2
C3
C4
C5
C6
C7
T1
T2
T3
T4
T5
T6
T7
T8
T9
T10
T11
T12
L1
L2
L3
L4
L5
Element
71
Burial Number:
Age:
Sex:
Body
Preservatio
n
Neural Arch
Preservatio
n
Unc. Proc.
Right
CV Facet
CT Facet
OP LP PT NB EB OP LP PT NB EB OP LP PT NB EB
Legend:
Unc. Proc. = Unciate Process
CV Facet = Costovertebral Facet
CT Facet = Costotransverse Facet
LF = Ossification of the Ligamentum Flavum
ALL = Ossification of the Anterior Longitudinal Ligament
PLL = Ossification of the Posterior Longitudinal Ligament
C1
C2
C3
C4
C5
C6
C7
T1
T2
T3
T4
T5
T6
T7
T8
T9
T10
T11
T12
L1
L2
L3
L4
L5
Element
LF
Site:
Context:
Date:
Feature
Unc. Proc.
Left
CV Facet
CT Facet
OP LP PT NB EB OP LP PT NB EB OP LP PT NB EB
LF
ALL PLL
72