Biology Magazine

Neanderthal with Scoliosis Sheds Light on Healthcare

Posted on the 23 August 2018 by Reprieve @EvoAnth

In 1908 an artist drew the classic "ape-like" Neanderthal. When published in the Illustrated London News the following year, it cemented their place in popular culture as primitive brutes.

However, that same year archaeologists discovered a complete Neanderthal skeleton in La Ferrassie. This first fossil from the site, given the creative name of LF1, had several human-like attributes which would help dispel this stereotype.

More than 100 years later, LF1 is still shedding light on Neanderthal behaviour. Work by Gomez-Olivencia et al. reveals that they were plagued with health conditions; ranging from broken bones to scoliosis 1.

Such a tough existence was probably only possible with help from the tribe, helping confirm another human-like trait in the species: healthcare 1.

A tough time for LF1

LF1 was a 50-year-old male at the time of death. Now, they're a ~54,000-year-old fossil, almost completely preserved except for their knee bones and some smaller hand/foot bones 1.

In fact, we know they're more complete than we thought back in 1909. Other bits of them have been found at La Ferrassie (or amongst miscellaneous material recovered from the site) and Gomez-Olivencia et al. carried out a CT scan of their face. This revealed their ear bones were still in situ in their ear holes 1.

Of course, we didn't have to wait until we found LF1's ear holes to realise they had a tough time in life. We've known about various damage and disease since pretty soon after the first discovery. However, early techniques were imperfect, leading to ongoing debate. For instance, LF1's left collarbone is a bit funky looking. Is this asymmetry a sign of damage during life, or an indication they were left-handed 1?

So, Gomez-Olivencia et al. set out to resolve these disagreements using the latest technology (and all of LF1's "new" bones). Taken together, they discovered the dude had:

  • Broken his collarbone early in life, creating the aforementioned funky look (aka, he wasn't left-handed)1.
  • Broken his femur, which did heal but may have left him with an asymmetrical gait1.
  • 2 instance of scoliosis! One near the top of his spine, the other further down. The latter may have been caused by the weird gait his broken leg gave him1.
  • Several lesions in his ribs, possibly connected to a recent pulmonary infection. This may have been the cause of death1!

Caring for a Neanderthal with scoliosis

It's all well and good describing random anatomical abnormalities, but what does it all mean? Would it have impacted LF1's life?

On their own, each feature may not have been that problematic as they aren't particularly severe (which may have been why it took 100 years to find some of them). However, when you put them altogether things are looking bad for LF1.

The damage to his leg and resulting scoliosis would have probably had a pretty big impact on his gait. The damage to his shoulder would also have led to a noticeable deformity there, possibly limiting his range of movement. And the pulmonary infection may well have caused breathing problems and - depending on the exact condition - finger clubbing1.

Crucially, most of these would have arisen early in life. His shoulder damage, for instance, likely happened in childhood before the bones had fully developed. His broken leg also appears to have been an early injury. Yet LF1 managed to survive until he was 50, despite the resulting problems and scoliosis.

Such survival was probably only possible with lifelong care provided by his tribe. Now, we know ancient humans provided long-term care for their elderly. But they may have earned it with contributions to the group when younger, or provide wisdom or some other surface. LF1 was struck down in the prime of life, yet still received that same healthcare.

Clearly, ancient healthcare was socialist, independent of your ability to pay into the system.


This caring attitude extended into death. The re-analysis by Gomez-Olivencia et al. discovered that the bones had a lot of post-death damage, consistent with a deliberate burial.

This damage mostly consists of long fractures. These tell a story of bones that were buried shortly after death, before carnivores or the elements could have their way with them. Once buried, the bones dried out (and his flesh rotted away). This made them vulnerable to being crushed by the build-up up of sediment over the next 54,000 years 1.

Neanderthals were clearly caring, keeping LF1 alive for decades despite health problems. And that care continued after his death, preserving him for millennia to come. It's thanks to deliberate actions by Neanderthals that we have such a good fossil here. A fossil that helped rehabilitate their image, from ape-like savages to caring individuals who helped people with scoliosis.

The good work of Neanderthals lives on.


    Gómez-Olivencia, A., Quam, R., Sala, N., Bardey, M., Ohman, J.C. and Balzeau, A., 2018. La Ferrassie 1: New perspectives on a "classic" Neandertal. Journal of human evolution, 117, pp.13-32.

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