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This communication documents one of the earliest verifiable cases of human paralysis associated with severe spinal pathology. A series of skeletal abnormalities is described for a young adult male (M9) from a Southeast Asian Neolithic community. Differential diagnosis suggests that M9 suffered from a severely disabling congenital fusion of the spine (Klippel-Feil Syndrome, Type III), resulting in child-onset lower body paralysis at a minimum (maximally quadriplegia). M9 experienced severe, most probably total, incapacitation for at least a decade prior to death. In the prehistoric context, this individual's condition would have rendered him completely dependent on others for survival.

Explanations for patterns of healed trauma in Neanderthals have been a matter of debate for several decades. Despite widespread evidence for recovery from injuries or survival despite impairments, apparent evidence for healthcare is given limited attention. Moreover, interpretations of Neanderthals' approach to injury and suffering sometimes assume a calculated or indifferent attitude to others. Here the authors review evidence for Neanderthal healthcare, drawing on a bioarchaeology of care approach and relating healthcare to other realms of Neanderthal social life. The authors argue that Neanderthal medical treatment and healthcare was widespread and part of a social context of strong pro-social bonds which was not distinctively different from healthcare seen in later contexts. They suggest that the time has come to accept Neanderthal healthcare as a compassionate and knowledgeable response to injury and illness, and to turn to other questions, such as cultural variation or the wider significance of healthcare in an evolutionary context.

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