Scythian trepanations in the Gorny Altai in Hippocratic times: modern expert appraisal of ancient surgical technologies.

Objective: To report the analysis of 3 cases of ancient trepanation discovered in the craniological collection (153 skulls) of the Pazyryk nomadic culture (500-300 bc) from the Gorny Altai, Russia, and to evaluate the technique, instrumentation, and materials used for cranial surgery as well as the motivation for the trepanations in Scythian times.

Methods: A multidisciplinary approach was chosen to study the trepanned skulls. Visual inspection and examination under magnification, multislice computed tomography, high-field magnetic resonance imaging, and coupled plasma mass spectrometry and synchrotron radiation-induced x-ray fluorescence analysis of the bone samples from the site of trephination were used.