A note on bent spines: 'camptocormia' and 'head ptosis'.

quently so regarded [6, 7] . Souques in 1915 [8] originally used the term camptocormia. Rosanoff-Saloff provided a photographic record of Souques’ case study of a soldier’s bent back and his recovery. According to the English translation in Southard’s collection of shell shock cases [9] , this soldier was wounded 5 months previously by a bullet that entered near the scapula and emerged near the spine. ‘He spat blood for several days ... and when he got up his trunk and thighs were found to be in a state of moderate fl exion upon the pelvis, the trunk being bent almost at a right angle.’ He was able to bend his trunk still further forward than ‘its habitual contractured position’ and it was evident that there was contraction of the muscles of the abdominal wall and of the iliopsoas. ‘No motor, sensory, refl ex, trophic, vasomotor, electrical, visceral or Xray disorders could be found.’ The application of plaster corsets ‘cured’ this man’s deformity within six weeks [10] . It was known as cintrage (arching), suggesting that it was a common amongst French soldiers [11] . Roussy and Lhermitte reported subsequent cases (Southard): ‘An infantryman was thrown into the air by the bursting of a shell, rendered unconscious and recovered experiencing violent pains in the back. He remained stooped to the right. His bent back was corrected by the application of plaster corsets. Another reported case was a chasseur who was buried in an explosion, knocked unconscious, and experienced acute respiratory distress, and subsequent mutism and camptocormia. One séance of Many deplore the journalistic trend to label well-recognized conditions by acronyms, or by recently invented names – commonly to no useful purpose. Head ptosis (syn head drop) is an allied condition, but why perpetuate the ungainly phrase head ptosis? Ptosis (Greek for falling) has traditionally been applied only to the upper eyelid and to prolapse of any of the viscera. The phrase ‘Head drop’ is short, its meaning unequivocal. Camptocormia (Greek karmos bent + kormos trunk of a tree) is a similarly clumsy term applied to signify a bent spine. It is an ostentatious word that portends something more arcane than a bent back or neck [1] . Some degree of spinal fl exion is almost invariable with normal ageing, osteopenia plays a part, but the mechanisms are not fully understood. It becomes pathological when causing symptoms or disability. Both head ptosis and camptocormia occur mainly in those over the age of 60. Idiopathic camptocormia is uncommon, evident as involuntary trunkal fl exion when the patient is erect [2] . It lessens when the patient is supine, a sign used to exclude the fi xed deformities of ankylosing spondylitis and degenerative spondylosis [3] . Head drop and camptocormia include protean disorders that affect different parts of the spine resulting in abnormal and sometimes painful, disabling kyphosis (Greek ku = ––fo––s = = crooked). Many are of unknown cause. When severe, patients are so bent that many normal activities are diffi cult or impossible. Camptocormia was reported as a psychogenic illness among soldiers in both World Wars [4, 5] and was subseReceived: November 29, 2004 Accepted: November 29, 2004 Published online: April 26, 2005