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Estimation of stature from vertebral column length in South Indians

Article  in  Legal Medicine · November 2006


DOI: 10.1016/j.legalmed.2006.05.007 · Source: PubMed

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Kr Nagesh Gouda Pradeep Kumar


Father Muller Medical College Manipal Academy of Higher Education
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CONTENTS

1. Introduction 03

2. Aims and objectives 06

3. Review of literature 07

4. Material and methods 35

5. Results 38

6. Discussion 45

7. Summary 48

8. References 50

1
ACKNOWLEDGEMENT

This work is submitted to Manipal Academy of Higher Education (currently Manipal

University) in partial fulfillment of the University regulations for the award of µ'RFWRU RI

0HGLFLQH¶Gegree in Forensic Medicine in 2003. My sincere thanks to the Manipal University

for giving permission to publish this work in to a book.

I wish to record my deep sense of gratitude to my teacher Dr. G Pradeep Kumar,

Professor and Head, Department of Forensic Medicine, Kasturba Medical College, Manipal,

who stood beside me and proffered his valuable guidance, support, and encouragement

throughout this work.

I am extremely thankful to Dr. KWD Ravichander, Former Professor and Head,

Department of Forensic Medicine, Bangalore Medical College, Bangalore for his valuable

help in compiling the materials for this work.

I thank Dr. Sreekumaran Nair, Professor and Head, Department of Statistics, Manipal

University for his invaluable help in the statistical analysis of the data in this work.

I am gratefully indebted to my teachers, colleagues, friends and non-teaching staff of the

Department of Forensic Medicine, Kasturba Medical College, Manipal for their

encouragement and cooperation in completing this work.

K.R. Nagesh

2
INTRODUCTION

´/RRNEHQHDWKWKHVXUIDFHQHYHUOHWDWKLQJ·V

LQWULQVLFTXDOLW\RUZRUWKHVFDSH\RXµ

(Marcus Aurelius, Meditations VI: 3)

Every person has got the right to be identified -- at birth, during life, and

in death. Identity is the aggregate of characteristics by which an individual is

recognized by himself and others.1 It is an essential requirement of any

medicolegal investigation as the mistaken identity may pose a problem in

delivering the justice. Identification of the criminal and other persons, dead

bodies, or human organs is very important, because identity is a part and parcel

of corpus delecti or the body of crime, which helps in connecting the criminal to

the crime. Trials in civil and criminal courts depend upon establishing proper

identity.

Identification of a living person is mostly the concern of the police, and is

raised in the criminal courts in connection with absconding criminals, assault,

rape and murder. It is also frequently raised in civil courts owing to fraudulent

personation practiced by people to secure unlawful possession of property,

insurance claims or to obtain the prolongation of a lapsed pension. Identification

of a dead body is required in cases of sudden and unexpected death, fires,

3
explosions, railway or aircraft accidents, mutilated or hidden decomposed

bodies, or foul play and often needs great medicolegal acumen.

The identification of a dead body becomes very difficult in tropical

countries like India, owing to its rapid decomposition in summer or mutilation

by animal scavengers. Sometimes, portions of a dead body and even bones are

brought to support false charges. In these cases, the skeleton or parts of the

skeleton may help in the identification of a missing person. The determination

of sex, age, and stature of the bone gives valuable information in establishing

the identity of a person.

The determination of stature from human skeletal remains is a recurrent

problem in forensic science, and has been an area of critical interest to physical

anthropologists. Estimation of stature from different body parts with the help of

various statistical methods were being reported for a very long time, long bones

of the limb conventionally served the purpose so far. However, there are

circumstances where determination of stature is required in cases where no limb

bones are available for measurement. In such cases, parts of the body or bones

that tend to remain intact long after death such as the spine can be used for

measurement.

4
There is a very little effort in the literature where the length of the spine is

utilized for the estimation of stature. Considering this fact, the present study

attempts to throw a light in this unexplored arena of identification.

5
AIMS AND OBJECTIVES

To estimate the stature from:

x The total length of vertebral column.

x The length of cervical segment of vertebral column.

x The length of thoracic segment of vertebral column.

x The length of lumbar segment of vertebral column.

x The combined length of cervical and thoracic segments of vertebral

column.

x The combined length of thoracic and lumbar segments of vertebral column.

6
REVIEW OF LITERATURE

Identification of a person assumes a great medicolegal importance. It is

required in civil cases such as insurance claims, pension, inheritance, marriage,

disputed sex and missing persons. It is also required in criminal cases such as

assault, rape, murder etc.

Identification of a living person is usually carried out by the police.

However, where medical knowledge is needed, a medical man may be

consulted.2 Whenever a person is convicted for criminal offence, the police

prepares a file, which consists of personal details such as the name of person,

his alias, residence, occupation, age, height, build, birth mark, colour of skin,

hair and eyes, photograph, and fingerprints. Whenever a suspect is arrested, his

record is searched in the police file, which may help in the identification of a

criminal.3

Identification of a dead body is one of the objectives of medicolegal

autopsy. It is required in unnatural deaths such as fires, explosions, travel

accidents, mutilated and decomposed bodies. However, the pooling and

compiling of information from the relatives and investigating authorities leads

to the successful identification.2

7
In the absence of police records, living persons were identified by their

personal impressions - recognition by sight or hearing. It is still in practice to

hold an identification parade, which includes the inclusion of a suspect or

accused in a group of individuals of similar features, and the witness / witnesses

are invited to point out the alleged criminal. However, relying on personal

impressions, the witness might make mistakes in recognising a person.

Handwriting, gait, speech, testing of mental calibre and educational status

constitute the other means of identification in the living. Eventhough

photography is a valuable tool in the identification of the living, there are

circumstances where even excellent photographs can lead to an error in the

identification.2

Identification of the dead can be made by establishing the features such as

race, sex, age, stature, colour of eyes and hair, dentures and dental fillings, scar,

tattoo marks, external peculiarities and deformities, clothing and objects on or

near the body, such as pocket books and papers, identity card, watch, rings, etc.4

The application of fingerprints, footprints, lipprints, palatalprints and

DNA fingerprinting showed a great improvement in the field of identification.

As they are individualistic and constant throughout life, they help in the

identification of both the living and dead. Fingerprints or dactylography is

the study of epidermal ridges and their configurations (dermatoglyphics) in the

8
palms and soles. Poroscopy, the study of minute pores along the papillary ridges

of epidermis helps in the positive identification. Lipprints or cheiloscopy is the

study of furrows or grooves present in the lips. Palatalprints or Rugoscopy is the

study of rugosity of palate.5

DNA fingerprinting helps the investigators in achieving identification of

a person with pinpoint accuracy. From DNA fingerprinting, a complete

identification is possible even with a few drops of blood or other body fluids, or

a small piece of tissue, hair, bone, etc. This can be accomplished even in the

absence of antemortem records of the deceased, since his DNA can be

compared with that of his close blood relatives.5

In highly decomposed, mutilated or skeletalised bodies, the examination

of fragmentary remains or skeletal remains of a body may help in the

identification of a missing person. Invaluable information could be derived from

the following criteria in establishing the identity:

x Sex

x Age

x Stature

Whenever it is possible to tell the sex of the person, identification is

simplified in that only the missing person of one sex needs to be considered.

9
During intrauterine life, the sex differentiation is possible from 14th week of

gestational period.6 In living persons and dead bodies, the sex could be

identified from the dress, ornaments, sex organs, and secondary sexual

characters. In highly decomposed bodies where soft tissue morphology is lost or

distorted, the prostate and the uterus may still be identifiable and may help to

determine the sex. When the skeletal remains are recovered, the sex can be

determined with 100 % accuracy from the whole skeleton, 98 % accuracy from

the skull and pelvis together, 95 % accuracy from the pelvis alone, 90 %

accuracy from the skull alone, and 80 ± 85 % accuracy from the long bones.

However, recognizable sex differences do not appear until after puberty except

the pelvis.7

Once the sex is determined, the next important parameter in the

identification process is the determination of age. This could be done during

different stages of development, by considering the following factors:8

x In Foetus and Infant: Length, weight, appearance of ossification centers

and deciduous teeth.

x In children and adolescents: Length, weight, appearance of ossification

centers, epiphyseal fusion and teeth eruption.

x In adults and elderly persons: Fusion of skull sutures, changes in articular

surface of pubic symphysis, secondary changes in teeth by applying

10
Gustafson's criteria, and arthritic changes, senile changes in the skin and

eyes, hair colour and loss, and arterial degeneration.

The accuracy rate for the determination of age is within weeks in foetus

and infants, within months to a year in children and adolescents, and in decades

in adult and elderly persons.8 Pubic symphyseal changes are considered as a

reliable index for ageing male skeletons, whereas the parturition has modifying

effect in females.2 The examiner should utilise the information from all

available bones before reaching a final conclusion.

Identification process will be more accurate if the stature is determined

along with sex and age. Stature is the height of a person or the length of a body.

STATURE IN LIVING:

Basically, total stature in the living is made up of head height, vertebral

column length, lower extremity length and foot height. The head height is the

basio-bregmatic length, vertebral column length is from C2 to S1, lower

extremity length is the combination of the morphological length of the femur

and tibia, and the foot height is the talo-calcaneal height.9

Stature of a person increases progressively and becomes maximum at the

age of 20-25 years.7 It decreases approximately 6 mm per decade after the age

11
of 30 years owing to decreased elasticity of the intervertebral discs and

cartilage. Further, the stature tends to decrease by 1 ± 2 cms during the period

from getting up to going to bed. This decrease is due to decreased elasticity,

compression of intervertebral discs and joint cartilages, and the load carried by

the body during walking or sitting. Such a load may be due to both the body

weight and the actual loads carried or lifted.10

Although it was widely accepted that persons become shorter as they

grow older, most estimates of the rate of decline were based largely on cross-

sectional studies and were confounded by secular changes and individual

variation. A study was done by Chandler P J et al using mixed series of

longitudinal physical measurements on the population of Busselton, Western

Australia. The results showed a significant sex difference, with females

declining at a greater rate than males, particularly after the age of forty years. 11

Whereas, the study done by Cline M G et al showed a significant decrement in

height from the age of forty years, in both sexes.12

Studies have been done by Zhang H et al, Donini L M et al, and Han T S

et al to estimate the stature in elderly people by using the knee height. They

concluded that the knee height is independent of age and provides a valid

estimate of maximum stature. 13-15

12
The foot, like other major parts of human body such as the trunk and

limbs, exhibit an allometric relationship with total body height. Therefore, the

height of a person can be estimated from the foot measurement. Footprints are

found at almost every crime scene. Various dimensions of foot and shoe prints

can be measured and with the help of suitable statistical formulae, the height

and weight of a person can be estimated. 16-20

The step length, which is a product of movement of lower limbs and

pelvic girdle when a person is walking, is helpful in estimating the stature of an

individual in a normal pattern of walking.21 Further, the step length varies with

walking speed ± the greater the walking speed, the longer will be the step

length. It was found that, eventhough the formulae for stature estimation differ

between normal and fast walking, the range of error remains the same,

therefore, the reliability for estimating stature remains the same. However, one

should be careful in using these formulae for other population, as the study

sample may exhibit regional and ethnic variation due to heredity and various

environmental conditions such as climate and nutrition.22

STATURE IN DEAD:

Soon after death, the length of the body increases by 2.0 - 2.5 cm due to

primary relaxation of the muscles. Later, the length decreases with the

13
development of rigor mortis. Again with the passage of rigor mortis and onset

of putrefaction, the length increases due to secondary relaxation.2

Lengths of different body parts bear more or less some constant

relationship with the body length. Hence, if dismembered body parts and bones

are available, the stature of the person can be calculated as follows:7

x When both arms are outstretched in a straight line, the distance between the

tips of the middle fingers of both hands approximates to the stature of the

person.

x Stature is equal to twice the length from vertex to symphysis pubis or equal

to twice the length from symphysis pubis to the heel on one side, with the

hip and knee extended and the ankle dorsiflexed.

x Stature is equal to the length of one arm in cm (from tip of middle finger to

the acromion process) multiplied by two and adding 34 cm (30 cm for the

length of two clavicles and 4 cm for the breadth of the manubrium).

x Stature is 3.3 times the length from the sternal notch to the symphysis pubis.

x Stature is 3.7 times the distance between the tip of olecranon and tip of

middle finger of the same side.

When complete skeleton is available, the anatomical method is preferred

over the mathematical method. The anatomical method involves measuring all

of the skeletal elements that contribute to height and adding a constant of 10 -

14
12 cm to account for soft tissue and other distances that are not taken into

account by the measurements. The mathematical method was based upon the

proportion of certain bones to stature of a person.23

Skeletal development is influenced by a number of factors producing

differences in skeletal proportions between different geographical areas.

Therefore, individuals of same stature in a given population may vary in the

body proportions. This means that for every given stature there are individuals

with long trunks and short extremities or short trunks and long extremities,

although the proportions are centered on mean population values. In general,

higher the correlation between the skeletal measurements and the stature, the

more accurate will be the estimate of the stature.10

STATURE FROM THE VERTEBRAL COLUMN: 24

The vertebral column, also called the spine or backbone, together with the

sternum and ribs, forms the skeleton of the trunk of the body. The vertebral

column consists of bone and connective tissue, and is a strong, flexible rod that

bends anteriorly, posteriorly, laterally and rotates. It encloses and protects the

spinal cord and supports the head. It also serves as a point of attachment for the

ribs, pelvic girdle, and muscles of the back.

15
The vertebral column makes up about two-fifths of the total height of the

body and is composed of a series of bones called vertebrae. Totally there are

thirty-three vertebrae ± seven cervical, twelve thoracic, five lumbar, five sacral,

and four coccygeal.

Between the bodies of adjacent vertebrae from the second cervical

vertebra to the sacrum are intervertebral discs. Each disc has an outer fibrous

ring consisting of fibrocartilage called the annulus fibrosus and an inner soft,

pulpy, highly elastic substance called the nucleus pulposus. The discs form the

strong joints, permit various movements of the vertebral column, and absorb

vertical shock. When compressed, they flatten, broaden, and bulge out from

their intervertebral spaces. The intervertebral discs of the cervical, thoracic and

lumbar segments constitute about one-fourth of the length of the vertebral

column.

When viewed from the side, the vertebral column shows four normal

curves. The cervical and lumbar curves are anteriorly convex (bulging out),

whereas the thoracic and sacral curves are anteriorly concave (cupping in). The

curves of the vertebral column are important because they increase its strength,

help to maintain balance in the upright position, absorb shock during walking,

and help to protect the column from fracture.

16
In the foetus, there is only a single anteriorly concave curve. The thoracic

and sacral curves are called primary curves because they form first during foetal

development. The cervical and lumbar curves are referred to as secondary

curves because they begin to form later, several months after birth. At

approximately the third month after birth, when an infant begins to hold its head

erect, the cervical curve develops. As the child starts to sit up, stand and walk,

the lumbar curvature develops. All the curves are fully developed by the age

ten.

General characteristics of Vertebra:25

Although vertebrae show regional differences, they possess a common

pattern. A typical vertebra consists of a rounded body anteriorly and a vertebral

arch posteriorly. These enclose a space called the vertebral foramen, through

which runs the spinal cord and its coverings.

The vertebral arch consists of a pair of cylindrical pedicles, which form

the sides of the arch, and a pair of flattened laminae, which complete the arch

posteriorly. The vertebral arch gives rise to seven processes: one spinous, two

transverse, and four articular. The spinous process is directed posteriorly from

the junction of the two laminae. The transverse processes are directed laterally

from the junction of the laminae and the pedicles. The articular processes

17
consist of two superior and two inferior processes, which arise from the junction

of the laminae and the pedicles.

Characteristics of a Typical Cervical vertebra:25

x Transverse process posses a foramen transversarium for the passage of the

vertebral artery and veins.

x Spines are small and bifid.

x Body is small and broad from side to side.

x Vertebral foramen is large and triangular.

x Superior articular processes have facets that face backward and upward; the

inferior processes have facets that face forward and downward.

Characteristics of an Atypical Cervical vertebra:25

The first, second, and seventh cervical vertebrae are atypical.

First Cervical vertebra or Atlas:

x Does not possess a body.

x Does not have a spinous process.

x Has an anterior and posterior arch.

x Has a lateral mass on each side with articular surfaces on its upper surface

for articulation with the occipital condyles (atlanto±occipital joints) and

18
articular surfaces on its lower surface for articulation with the axis (atlanto±

axial joints).

Second Cervical vertebra or Axis:

x Has a peglike odontoid process that projects from the superior surface of the

body, representing the body of the atlas.

Seventh Cervical vertebra or Vertebra prominens:

x Has the longest spinous process and is not bifid.

x Transverse process is large, but the foramen trasversarium is small and

transmits only the vertebral vein.

Characteristics of a Typical Thoracic vertebra:25

x Body is medium sized and heart shaped.

x Vertebral foramen is small and circular.

x Spines are long and inclined downward.

x Costal facets are present on the sides of the bodies for articulation with the

heads of the ribs.

x Costal facets are present on the transverse processes for articulation with the

tubercles of the ribs (T11 and T12 have no facets on the transverse processes).

19
x Superior articular processes bear facets that face backward and laterally,

whereas the facets on the inferior articular processes face forward and

medially. The inferior articular processes of the 12th vertebra face laterally,

as those of the lumbar vertebrae.

Characteristics of a Typical Lumbar vertebra:25

x Body is large and kidney shaped.

x Pedicles are strong and directed backward.

x Laminae are thick.

x Vertebral foramina are triangular.

x Transverse processes are long and slender.

x Spinous processes are short, flat, quadrangular and projects backward.

x Articular surfaces of the superior articular processes face medially, and those

of the inferior articular processes face laterally.

Embryology of Vertebral column:26

Vertebral column begins to develop from the 4th week of intrauterine life.

It is formed from the sclerotomes of the somites, a derivative of mesoderm.

Each sclerotome divides into three parts: cranial, middle and caudal. The caudal

part of one sclerotome and the cranial part of the next sclerotome fuse to form a

vertebra, whereas the middle part of the sclerotome forms an intervertebral disc.

20
Ossification of vertebral column:27

A typical vertebra is ossified from three primary centers, one in each half

of the vertebral arch and one in the centrum. Classically centers for vertebral

arches appear first in the upper cervical vertebrae in the 9 th to 10th week,

spreading caudally and reaching the lower lumbar level in the 12 th week.

Whereas the center for centrum first appears in the lower thoracic vertebrae in

the 9th to 10th week, spreading craniocaudally and reaching the second cervical

vertebra in the 12th week.

At birth, a vertebra consists of three ossifying elements: a centrum and

two half arches, united by cartilage. During the first year the arches unite

behind, first in the lumbar region and then in the thoracic and cervical regions.

In upper cervical vertebrae, the centrum unites with the arches by about the

third year and in lower lumbar vertebrae about the sixth year. At puberty, five

secondary centers appear, one in the apex of each transverse and spinous

process and two annular epiphyseal rings for circumferential parts of upper and

lower surfaces of the body. These epiphyses fuse with the rest of the bone at

about 25 years.

Growth of vertebral column:27

Vertebral column growth is due to the summation of growth of individual

vertebrae, which is influenced by sexual, hormonal, genetic, biomechanical and

21
other factors. Growth in the vertebral column is due to proliferative changes in

the cartilaginous end plates, similar to the epiphyseal cartilages of long bones.

Growth spurts within the vertebral column occurs in males between ages 13 and

15 years, in females between 9 and 13 years. Although growth in standing

height is usually completed by 18 years in Caucasian girls and 20 years in

males, evidence has been found to suggest that vertebral growth may continue

well into adulthood.

Estimation of Stature from Vertebral column:

Dwight, in 1894 published a study in which he introduced a method for

the estimation of stature using the spine. He dissected the spines of the cadavers

and measured their lengths from the top of atlas to the promontory of sacrum.4

Fully and Pineau, in 1960 studied the skeletal remains to estimate the

stature in white males by considering the length of spine and long bones of

lower limb, and the foot height. Each vertebra from C2 ± S1 was measured

individually, the oblique length of the femur rather than the projected maximum

length was used, tibial length was taken between the articular surfaces of femur

and talus excluding the length of the malleolus, and the foot height was

measured by the combined height of the talus and calcaneum after articulation.

Concurrently, Fully and Pineau developed equations to sum up the total added

heights of L1 ± L5 and the morphological length of the femur or the tibia.

22
However, they stated that while these formulae were developed exclusively for

white males, it could be recommended for females and other race also.9

Tibbetts, in 1981 studied the estimation of stature from vertebrae in both

sexes of American blacks. He measured the maximum midline height of each

vertebral body on the ventral surface, from the second cervical to fifth lumbar

vertebrae. Each vertebra was measured one at a time, two at a time (e.g. C 2 - C3;

C3 - C4), three at a time (e.g. C2 - C4; C3 - C5) and so on and so forth. His study

showed a correlation coefficient of 0.62 and 0.64, with standard errors 5.47 -

6.79 cm and 5.31 - 6.83 cm in males and females, respectively. He also

compared the percentage of each individual vertebra to the vertebral column

length. In the case of missing vertebra, the total length of the vertebral column

can be estimated from its percentage contribution to the total length of the

column.28

7KH RYHUDOO FRQFOXVLRQ RI 7LEEHWW¶V VWXG\ ZDV WKDW WKH HVWLPDWLRQ RI

stature from vertebral column segments could be assessed with 38% accuracy in

males and 41% in females. However, he admits that the corresponding figures

for long bones were 74% in males and 72% in females as determined by Trotter

and Glesser.28

23
Terazawa et al, in 1990 derived regression equations for the estimation of

stature from the length of the lumbar part of spine (LLPS) in Japanese males

and females. Their study showed a correlation coefficient of 0.532 and 0.440,

with standard errors of 6.16 cm and 4.05 cm in males and females,

respectively.29

Jason D R et al, in 1995 conducted a study to estimate stature from the

different segments of spine in both sexes of American whites and blacks. The

results of their study were as follows:30

x Cervico-thoraco-lumbar length of spine: The correlation coefficient was

0.768 and 0.809 in white and black males, and 0.720 and 8.06 in white and

black females, respectively. The standard error was 5.29 cm and 5.09 cm in

white and black males, and 5.32 cm and 3.62 cm in white and black

females, respectively.

x Thoraco-lumbar segment: The correlation coefficient was 0.712 and 0.765

in white and black males, and 0.690 and 0.823 in white and black females,

respectively. The standard error was 5.91 cm and 5.82 cm in white and

black males, and 5.72 cm and 2.60 cm in white and black females,

respectively.

x Thoracic segment: The correlation coefficient was 0.669 and 0.720 in white

and black males, and 0.667 and 0.819 in white and black females,

respectively. The standard error was 6.03 cm and 6.09 cm in white and

24
black males, and 6.08 cm and 3.58 cm in white and black females,

respectively.

x Lumbar segment: The correlation coefficient was 0.598 and 0.623 in white

and black males, and 0.537 and 0.686 in white and black females,

respectively. The standard error was 6.66 cm and 6.74 cm in white and

black males, and 6.87 cm and 4.32 cm in white and black females,

respectively.

x Cervical segment: The correlation coefficient was 0.626 and 0.735 in white

and black males, and 0.468 & 0.353 in white & black females, respectively.

The standard error was 6.45 cm and 5.94 cm in white and black males, and

7.11 cm and 5.41 cm in white and black females, respectively.

Further, Jason D R et al examined the effect of ageing on the spinal

segment lengths in the white male series. They concluded that, a significant

change in the formulae with increasing age was observed only in the lumbar

and thoraco-lumbar segments. Whereas, the cervical, thoracic and entire

vertebral column have not showed such change.30

Todd and Pyle, in 1928 studied the effects of maceration and drying on

vertebrae. They found that drying of the cancellous tissue occurred within 14

days. The total column shrinkage was 2.7 % of the final summated length of the

25
dry bone. There is no constant relation of the summation of measurements of

individual vertebral lengths to articulated column length.9

Age changes in the vertebra:

Ericksen M F studied the lumbar vertebrae in both sexes, which showed a

significant decrease in height and increase in transverse breadth of the vertebral

body with advancing age. He found that the transverse breadth of the endplate

and the midbody will increase with age. The L3 and L4 vertebral bodies showed

greater broadening in the endplates, whereas the L5 showed a greater gain in the

midbody breadth. The L1 and L2 vertebrae showed minimal degree of increase

in all breadths. He also found that, with advancing age the posterior body height

decreases relative to anterior height, so that the lumbar bodies become wedge-

shaped. The posterior wedging of L3 and L4 vertebrae was more in males, where

as the L1 and L2 vertebrae was more in females. The L5 vertebra showed no

posterior wedging in both sexes. 31-33

Fang D et al, studied the computed tomography scans of Chinese

population to provide osteometric data on the Asian lumbar spine. The results

showed that in Asians there was a significant sex difference for vertebral body

and disc dimensions. The Asians have a smaller vertebral body in comparison to

the white population.34

26
Diacinti D. et al. performed the vertebral morphometry on lateral thoracic

and lumbar spine films in premenopausal and postmenopausal normal women.

Results showed that the vertebral heights were decreased with advancing age

and menopause. A statistically significant reduction of vertebral body heights

by 1 mm / vertebra / year was observed in post-menopausal women compared

to pre-menopausal women of the same age. The anterior, middle, and posterior

heights decreases by about 1.5 mm, 1.3 mm and 1.2 mm / year respectively.35

Ritzel H et al, studied the cortical thickness of the C3 ± L5 vertebral

bodies and concluded that there was a slight decrease of the cortical thickness

with aging. This decrease in cortical thickness is only significant below the T 8

vertebral body.36

STATURE FROM THE LONG LIMB BONES:

A variety of long limb bones may be used for the determination of

stature. When the skeleton is incomplete or severely disarticulated, the stature

can be calculated by applying mathematical formulae to the length of long limb

bones. These formulae vary in different races and sex. Use of Hepburn type

osteometric board gives most accurate measurements. The long bone is placed

lengthwise in between the two vertical planes of the board and the maximum

length of the bone is measured. Wet and humid bones are slightly longer than

the dry ones.2

27
Rollet, in1888 first devised the means of calculating stature from the long

bones. His calculations were based upon the measurement of the cadaveric

length of fresh long bones of male and female subjects in Lyons. Later, Karl

Pearson in 1899, published tables for the estimation of stature, which were

FRPSLOHGE\VXEMHFWLQJ5ROOHW¶VPDWHULDOWRPDWKHPDWLFDODQDO\VLV 4 His formula

gives different calculating factors for bones from males and females of

European subjects. For each long bone, there is a separate multiplying factor. A

measurement of 2.5 ± 4 cm is to be added for the thickness of soft parts.2

)XUWKHU3HDUVRQVWDWHGWKDW³WKHSUREDEOHHUURURIUHFRQVWUXFWLRQRIWKH

stature of an individual is never less than 2 cm, and if we have only the radius to

predict, it may be 2.66 cm. Hence, the reconstruction stature of an individual

IURPWKHIRXUORQJERQHVPD\QRWH[FHHGWKLVGHJUHHRIDFFXUDF\´3HDUVRQDOVR

stated that such formulae could not apply to persons at the extremes of statural

limits such as dwarfs or giants.9

Meanwhile, the Geneva agreement of the anthropologists was emerged

and recommended the use of maximum length for the reconstruction of stature

from long bones. It was suggested that the oblique length is to be considered in

case of femur and tibia.9

28
3HDUVRQ¶V IRUPXODe were accepted as the most satisfactory as that of

5ROOHW +RZHYHU RYHU D SHULRG RI WLPH LW ZDV DSSUHFLDWHG WKDW 3HDUVRQ¶V

formulae yielded under-estimates. Further, Pearson recognised the need for

separate formulae in both sexes for fresh and dried bones taking into

consideration the factors such as ageing of the subject and racial differences. 4

Many works have been done for the estimation of stature from long bones

in Indian population. People from the Indian subcontinent bear different

morphological features depending on their geographical distribution and

primary racial characters. Various multiplication factors were evolved to

calculate the stature from the long bones based on the works of Pan (1924) in

Bengal, Bihar, and Orissa, Nat (1931) in Uttar Pradesh, and Siddiqui and Shah

(1944) in Punjab.2

Dupertuis and Hadden, in 1951 made the calculations on the

measurement of cadaveric length and long bones in American whites and

blacks. They concluded that the combination of two or more bones gives more

reliable calculation than a single bone. They also stated that estimates from

lower limb bones were more accurate than the upper limb bones. However, their

formulae tend to yield results, which overestimate the stature.4

29
Trotter and Glesser, in 1952 published their study on estimation of stature

from the length of the long bones in American whites and blacks. Study samples

were taken from the casualties of World War II and the Terry collection. They

found that blacks have longer limb bones in relation to their stature. Hence,

different equations for the estimation of stature were established, for whites and

blacks in both sexes. In 1953, Harrison stated that the best estimate should

include all the information available and this involves either using a regression

formula based on all the available bones or averaging the estimates obtained

separately from all the bones.4

In 1958, Trotter and Glesser re-evaluated the entire problem of

reconstruction of the stature from long bones using the skeletal material from

casualties of Korean War. The bones of White, Negro, and Mongoloid groups

were considered for the study. They concluded that the relationships of stature

to the length of long bones differ among the three major races and suggested

different regressional equations for the estimation of stature in different races.9

Jantz R L, in 1992 studied the data from the Forensic Anthropology data

bank in the University of Tennessee and found that the female-stature

estimation formulae given by Trotter and Glesser were unreliable. The new

regression intercepts calculated by him showed an improvement of the formulae

in modern individuals.37

30
STATURE FROM THE FRAGMENTARY LONG BONES:

The estimation of stature of a living person from long bones is based

upon the principle that the various long bones of the limb correlate positively

with stature. Since this is true, the fragmentary parts of each individual long

bone should be related to stature even though they may not correlate as highly

as the length of the whole bone.

Muller, in 1935 has attempted stature estimation from the fragmentary

long bones in European whites using radius, humerus, and tibia. Steele and

Mckern in 1969, and Steele in 1970 have done similar studies among the North

American Indians, whites and blacks using the fragmentary remains of tibia,

femur and humerus. They deduced the ratio of various segments of long bones

in relation to their entire length, so that the length of a long bone could first be

estimated from its fragments, which can then be applied to regression formulae

to arrive at the stature.9

Joshi et al, in 1965 studied the relationship between tibial length, ulnar

length and total height. They found that more accurate stature could be

calculated when both tibia and ulna were considered together than

independently.38

31
Mysorekar et al, in 1980 established regression formulae for the

estimation of stature from the lower end of femur and upper end of radius. 39

In 1982, he also established regression formulae for the estimation of stature

from the upper and lower segments of humerus and radius.40

The studies of Steele and Mckern (1969), and Steele (1970) have not

proved satisfactory, because of the difficulty involved in identifying the precise

anatomical landmarks by which they are defined. In 1990, Tal simmons et al

conducted a study on fragmentary femora and redefined the landmarks, which

showed an improvement in the accuracy of stature prediction.41 In 1992,

Thomas Dean Holland conducted a study on the estimation of stature from the

measurement of tibial condyles in American whites and blacks, which are

helpful in the estimation of stature of an individual when less than intact

elements are recovered.42

Jose I Munoz et al, in 2001 studied the estimation of stature from

radiographically determined long bone length in the Spanish population and

found that the best results were obtained from the femur in males and from the

tibia in females.43 In 2002, Radoinova D et al studied the estimation of stature

from the lengths of humerus, tibia and fibula in Bulgarian population, which

showed good correlation.44

32
STATURE FROM OTHER BONES:

In the absence of measurable long bones, other skeletal elements such as

the skull, metatarsals, and metacarpals have been used for the estimation of

stature.

Musgrave and Harneja, in 1978 published the regression equations for the

estimation of stature from the length of metacarpals. It was found that these

values were smaller than the estimation made with long bones using Trotter and

*OHVVHU¶V IRUPXOD9 In 1992, Lee Meadows et al and Kimura K showed that

metacarpals could be employed for the estimation of stature in the absence of

long bones with good results.45-47

The somatometry of hand and sole are useful in the estimation of stature.

In 1984, Saxena S K and Bhatnagar D P et al studied the hand length, hand

breadth and sole length to derive a regression formula for the estimation of

stature, which showed a significant correlation.48,49 In 1989, Byres S et al

studied the foot bones to determine the stature from metatarsal lengths and

concluded that, eventhough the errors are larger compared to the stature

calculated from complete long bones, these equations are useful when only foot

bones are available.50 In 1990, Shintaku K et al derived the regression equations

to estimate the stature of Japanese women from the proximal phalangeal length

of the hand.51 In 1995, Holland T D derived the regression equations to estimate

33
the adult stature from the calcaneum and talus, which showed relatively

accurate results.52

Misako Chiba et al, in 1998 published the regression equations for the

estimation of stature from the somatometry of skull. They concluded that,

eventhough the standard errors appear to be larger than those obtained for other

parts of the body, their method could be useful in the absence of other parts of

the body.53

Campobasso C P et al, in 1998 showed that the stature of a person could

be determined from the intact and fragmented scapula. He stated that, in the

absence of other bones, scapula could be reliably employed in the estimation of

stature.54

34
MATERIAL AND METHODS

The medicolegal cases brought for autopsy to the mortuary of Kasturba

Medical College, Manipal and Bangalore Medical College, Bangalore were

included in the study. Materials for the study comprised 100 cases of above 20

years, belonging to the South Indian origin. The age of the individual was taken

from the police information and hospital records.

The exclusion criteria for the study:

x Highly decomposed bodies.

x Unidentified bodies due to the lack of information on age.

x Completely charred bodies.

x Vertebral fractures and dislocations.

x Age less than 20 years.

The body was placed in supine position on a flat surface with knee and

hip joints extended, and the neck in neutral position. The crown-heel length of

the body was taken, by measuring the length between two wooden planks, one

kept at the vertex of head and other at the heel. A flexible steel measuring tape

marked in centimeters was used for the measurement.

35
After complete evisceration of the organs of neck, thorax, and abdomen,

the anterior surface of the vertebral column was exposed. The soft tissues over

the anterior surface of vertebral bodies were cleared and the total vertebral

column length was measured along the curvature of vertebral column, between

the top of odontoid process of the second cervical vertebra and the point

between L5 ± S1, as recommended by Jason D R et al. The sacral length was not

included in the study.

T1 and T12 vertebrae were identified by following the first and twelth ribs,

which articulates with the body of corresponding vertebra, respectively. The

lengths of cervical, thoracic and lumbar segments of vertebral column were

measured separately. The segmental borders were defined at the mid portion of

the intervertebral discs as follows:

ƒ Cervical segment: From the top of odontoid process of C2 vertebra to the

point between C7 and T1.

ƒ Thoracic segment: The point between C7 and T1 to the point between T12

and L1.

ƒ Lumbar segment: The point between T12 and L1 to the point between L5

and S1.

The data were entered and analysed by using the FOX-based Statistical

Programme for Social Sciences (SPSS) computer programme. For assessing the

36
correlation between the stature and lengths of various segments of vertebral

column, thH3HDUVRQ¶VFRUUHODWLRQFRHIILFLHQWZDVFDOFXODWHGDQGLWVVLJQLILFDQFH

ZDV WHVWHG E\ VWXGHQWV ³W´ WHVW ³3´ YDOXH RI OHVV WKDQ  ZDV FRQVLGHUHG DV

significant.

37
RESULTS

The present study comprised of medicolegal cases autopsied in the

mortuary of Kasturba Medical College, Manipal and Bangalore Medical

College, Bangalore. The statistical data were analyzed and shown in the

following tables and graphs.

Table I: Sex distribution of the study sample.

Male Female Total

65 35 100

The total number of cases of the study sample is 100, of which 65 % were

males and 35 % were females as shown in table I.

Table II: Age group of the study sample.

Age (years)

Sex Minimum Maximum Mean SD

Male 21.00 80.00 36.74 12.89

Female 20.00 55.00 29.97 8.75

The age group of the study sample varies from 21±80 years in males and

20±55 years in females. The mean age for males is 36.74 r 12.89 years and for

females is 29.97 r 8.75 years, as shown in table II.

38
Table III: Age distribution of study sample.

Male Female

Age group (years) Number (%) Number (%)

20 ± 25 13 (20.00) 18 (51.43)

26 ± 30 17 (26.15) 9 (25.71)

31 ± 40 14 (21.54) 4 (11.43)

41 ± 50 13 (20.00) 3 (8.57)

51 ± 60 5 (7.69) 1 (2.86)

61 ± 70 2 (3.08) -

71 ± 80 1 (1.54) -

From table III, it is evident that the majority of cases fall within the age

group of 20±50 years (87.69%) in males and 20±30 years (77.14%) in females.

Table IV: Crown-heel length (CHL) of the study sample.

CHL (cm)

Sex Minimum Maximum Mean Standard deviation

Male 145.00 178.00 165.385 7.228

Female 144.00 167.00 153.457 5.533

39
The crown-heel length observed in the study sample is shown in the table

IV. It varies from 145±178 cm in males and 144±167 cm in females. The mean

length of the males is 165.385 r 7.228 and of the females is 153.457 r 5.533.

Table V: Length of vertebral column segments in male.

Segment* (cm) Minimum Maximum Mean Standard deviation

VCL 46.50 61.70 55.489 2.775

CSL 7.20 14.20 11.920 1.184

TSL 22.40 29.40 26.275 1.340

LSL 12.40 19.60 17.294 0.950

CTL 31.40 42.10 38.195 2.177

TLL 34.80 49.00 43.569 2.014

* VCL ± Vertebral column length, CSL ± Cervical segment length, TSL ± Thoracic segment length,

LSL ± Lumbar segment length, CTL ± Cervico-thoracic segment length, TLL ± Thoraco-lumbar

segment length.

The length of various segments of vertebral column observed in the males

is shown in table V. The total length of vertebral column varies from 46.50±

61.70 cm, with the mean length 55.489 r 2.775. The cervical segment length

varies from 7.20±14.20 cm, with the mean value 11.920 r 1.184. The thoracic

segment length varies from 22.40±29.40 cm, with the mean of 26.275 r 1.340.

40
The lumbar segment length varies from 12.40±19.60 cm, with the mean 17.294

r 0.950. The cervico-thoracic segment length varies from 31.40±42.10 cm, with

the mean 38.186 r 2.202. The thoraco-lumbar segment length varies from

34.80±49.00 cm, with the mean 43.569 r 2.014.

Table VI: Length of vertebral column segments in female.

Segment* (cm) Minimum Maximum Mean Standard deviation

VCL 47.40 56.20 51.726 2.144

CSL 8.30 12.50 10.789 1.078

TSL 22.40 26.00 24.546 0.899

LSL 13.70 17.90 16.391 1.003

CTL 32.20 38.30 35.334 1.516

TLL 36.40 43.90 40.937 1.627

* VCL ± Vertebral column length, CSL ± Cervical segment length, TSL ± Thoracic segment length,

LSL ± Lumbar segment length, CTL ± Cervico-thoracic segment length, TLL ± Thoraco-lumbar

segment length.

The length of various segments of vertebral column observed in the

females is shown in table VI. The total length of vertebral column varies from

47.40±56.20 cm, with the mean length 51.726 r 2.144. The cervical segment

length varies from 8.30±12.50 cm, with the mean value 10.789 r 1.078. The

41
thoracic segment length varies from 22.40±26.00 cm, with the mean of 24.546 r

0.899. The lumbar segment length varies from 13.70±17.90 cm, with the mean

16.391 r 1.003. The cervico-thoracic segment length varies from 32.20±38.30

cm, with the mean 35.334 r 1.516. The thoraco-lumbar segment length varies

from 36.40±43.90 cm, with the mean 40.937 r 1.627.

Table VII: Linear regression equations for stature estimation from the

vertebral column length in males.

Segment Equation# S.E. (cm) R R2 P

VCL y = 2.065 x + 50.776 4.4380 0.793 0.629 0.001

CSL y = 3.677 x + 121.557 5.8151 0.602 0.363 0.001

TSL y = 3.527 x + 72.711 5.5127 0.654 0.427 0.001

LSL y = 4.901 x + 80.633 5.5731 0.644 0.415 0.001

CTL y = 2.423 x + 72.837 4.9800 0.730 0.533 0.001

TLL y = 2.651 x + 55.641 4.9109 0.739 0.546 0.001

* VCL ± Vertebral column length, CSL ± Cervical segment length, TSL ± Thoracic segment length,

LSL ± Lumbar segment length, CTL ± Cervico-thoracic segment length, TLL ± Thoraco-lumbar

segment length. # y ± stature (cm), x ± segment length (cm).

Table VII shows the linear regression equations for the estimation of

stature in males, which are statistically significant (P=0.001). The standard error

of the estimate is 4.4380, 4.9109, 4.9493, 5.5127, 5.5731 and 5.8151 for the

42
total length of vertebral column, thoraco-lumbar, cervico-thoracic, thoracic,

lumbar and cervical segmental lengths, respectively. The highest coefficient

correlation is found with the total length of vertebral column (0.793), followed

by thoraco-lumbar (0.739), cervico-thoracic (0.734), thoracic (0.654), lumbar

(0.644) and cervical (0.602) segments. Hence, 62.9%, 54.6%, 53.8%, 42.7%,

41.5% and 36.3% of the variation in stature is explained by the variation in the

total length of vertebral column, thoraco-lumbar, cervico-thoracic, thoracic,

lumbar and cervical segmental lengths, respectively.

Table VIII: Linear regression equations for stature estimation from the

vertebral column length in females.

Segment Equation# S.E. (cm) R R2 P

VCL y = 1.946 x + 52.794 3.6874 0.754 0.569 0.001

CSL y = 2.744 x + 123.854 4.7451 0.535 0.286 0.001

TSL y = 3.228 x + 74.219 4.7814 0.524 0.275 0.001

LSL y = 3.131 x + 102.137 4.6239 0.567 0.322 0.001

CTL y = 2.391 x + 68.976 4.1535 0.673 0.453 0.001

TLL y = 2.175 x + 64.401 4.3168 0.640 0.409 0.001

* VCL ± Vertebral column length, CSL ± Cervical segment length, TSL ± Thoracic segment length,

LSL ± Lumbar segment length, CTL ± Cervico-thoracic segment length, TLL ± Thoraco-lumbar

segment length. # y ± stature (cm), x ± segment length (cm).

43
Table VIII shows the linear regression equations for the estimation of

stature in females, which are statistically significant (P=0.001). The standard

error of the estimate is 3.6874, 4.3168, 4.1535, 4.6239, 4.7451 and 4.7814 for

the total length of vertebral column, cervico-thoracic, thoraco-lumbar, lumbar,

cervical and thoracic segmental lengths, respectively. The highest coefficient

correlation is found with the total length of vertebral column (0.754), followed

by cervico-thoracic (0.673), thoraco-lumbar (0.640), lumbar (0.567), cervical

(0.535) and thoracic (0.524) segments. Hence, 56.9%, 45.3%, 40.9%, 32.2%,

28.6% and 27.5% of the variation in stature is explained by the variation in the

total length of vertebral column, cervico-thoracic, thoraco-lumbar, lumbar,

cervical and thoracic segmental lengths, respectively.

44
DISCUSSION

Body identification is one of the important aspects in forensic practice.

The chances of apprehending a criminal are greatly increased once the identity

of the victim has been established. Sometimes, after a murder, the body is

thrown into the jungle where it is mostly destroyed by decomposition or wild

animals, and only parts of the bones may be left over. In such situations, the

determination of sex, age and stature of the skeletal or mutilated body remains

may help in the establishment of identity of a deceased person. The estimation

of stature from skeletal remains has been an area of critical interest to physical

anthropologists. So far, the long bones of the limb served the purpose.

The present study was undertaken to determine the stature from the

vertebral column length. The regression equations were derived to estimate the

stature from various segments of vertebral column. The accuracy of determining

the stature from our study was found to be highest from the total length of

YHUWHEUDO FROXPQ ZKLFK LV LQ DFFRUGDQFH ZLWK -DVRQ¶V 30 study. However, the

EODFN IHPDOHV RI -DVRQ¶V VWXG\ VKRZHG JUHDWHU DFFXUDF\ IURP WKH WKRUDFR-

lumbar segment of vertebral column.

The correlation coefficient of our study for the total length of vertebral

column waVJUHDWHUWKDQWKHZKLWHSRSXODWLRQRI-DVRQ¶V 30 study, in both sexes.

45
+RZHYHUWKHEODFNSRSXODWLRQRI-DVRQ¶VVWXG\VKRZHGDKLJKFRUUHODWion value

WKDQ RXU¶V 7KH VWDQGDUG HUURU RI RXU VWXG\ IRU WKH WRWDO OHQJWK RI YHUWHEUDO

FROXPQ VKRZHG JUHDWHU DFFXUDF\ WKDQ -DVRQ¶V 30 study, except in the black

females. Similarly, a high correlation coefficient and standard errors were

observed in the present study for the total length of vertebral column when

compared to those of Tibbetts28 study. Probably, the use of dry individual

vertebrae for measurement without considering the intervertebral disc space

UHVXOWHGLQORZYDOXHVLQ7LEEHWWV¶VWXG\

The male population of our study showed a high correlation coefficient

for the thoraco-lumbar segment of vertebral column than the white male

SRSXODWLRQRI-DVRQ¶V30 VWXG\%XWWKHRWKHUJURXSVRI-DVRQ¶VVWXG\VKRZHGD

JUHDWHU FRUUHODWLRQ YDOXHV WKDQ RXU¶V 7he thoraco-lumbar segment showed

better standard error values in our study when compared to that of Jasons 30

study, except in the black females.

A comparatively high correlation coefficient and standard error was

found in our study for the lumbar segment of vertebral column when compared

to that of Jason's30 study, except in the black females. A high correlation

coefficient was established in our study from the length of lumbar segment of

YHUWHEUDOFROXPQZKHQFRPSDUHGWR7HUD]DZD¶V 29 study, in both sexes. Whereas,

46
the standard error in male population of our study for the lumbar segment was

better than Terazawa's study, except in the females.

The correlation coefficient of our study for the thoracic segment of

vertebral column is lower when compared to thDW RI -DVRQ¶V30 study, in both

sexes. The standard error of our study for the thoracic segment showed greater

accuracy when compared to that of Jason,s30 study, except in the black females.

A high correlation coefficient value was observed for the cervical

segment of vertebral column in the female population of our study than that of

Jason's30 study. Whereas, the male population of our study showed a low

FRUUHODWLRQ YDOXH WKDQ WKH -DVRQ¶V The cervical segment of vertebral column

showed a better standard error values in Jason's30 study when compared to that

of our study.

From the present study, it can be concluded that the vertebral column can

be a useful tool in the estimation of stature. In burnt and mutilated bodies where

in the limbs are unavailable, the application of our study may yield better values

in determining the stature of an individual, since the vertebral column is least

damaged in such cases.

47
SUMMARY

It is the duty of a medical officer to determine the true identity of

unidentified bodies and skeletal remains. One of the important parameter of

identification is stature.

Linear regression analysis were applied to the data collected from 65

male and 35 female autopsied cases of South Indian origin, to develop

regression formulae for the estimation of stature from the vertebral column.

Various segments of vertebral column such as cervical, thoracic, lumbar,

cervico-thoracic, thoraco-lumbar and cervico-thoraco-lumbar segments were

measured, and the regression formula for each segments were deduced.

The present study was undertaken for the reason that there is a paucity of

literature on similar studies in India. The results obtained have been discussed

in the light of the findings reported by other workers.

From the observations of present study, the following specific

conclusions were drawn:

x The vertebral column length can be used to estimate the stature, where

the long bones are not available.

48
x The cervico-thoraco-lumbar segment is likely to give more accurate

estimation, in both sexes.

x The other segments in males, which are useful in the estimation of stature

in descending order of frequency are, thoraco-lumbar, cervico-thoracic,

thoracic, lumbar and cervical segments.

x In females, the other segments that are useful in the estimation of stature

in descending order of frequency are, cervico-thoracic, thoraco-lumbar,

lumbar, cervical and thoracic segments.

Since stature varies in different population, similar study needs to be

conducted in different population of India. Additional research needs to be

conducted to determine the relationships between stature and vertebral segments

combined with the long bones.

49
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