The sella turcica, part of the sphenoid bone located at the base of the skull, is associated with multiple important neurovascular structures. Hence, a detailed knowledge of its variations is critical to clinicians who interpret imaging or surgeons who operate in this region. Our aim was to better understand the pathology of osteophytosis, often found related to the sella turcica. The study sample (n=1,083, human skulls) was obtained from the skeleton collection housed in the Natural History Museum, Cleveland, OH, USA. All skulls were assessed for osteophytes in the sella turcica region (defined as an overgrowth of 1 mm or more). Morphometrical measurements included skull length, width, and thickness, correlated to seller osteophytes. Cranial shape was related to the presence of osteophytes. Greater prevalence was seen in the brachycephalic skulls, with a significantly higher ratio of presence in older people (79.6%) compared to a younger population (26.4%);greater prevalence was also observed in female skulls with a composite thickness of the frontal, parietal and occipital bones.A multifactorial analysis using a logistic regression model defined a statistically significant model, by explaining 37.0% of the variance in osteophyte presence and correctly classifying 77.2% of the cases. Female skulls were 1.76 times more likely to display osteophytes of the sella turcica. Increasing age and increased skull thickness were associated with an enhanced likelihood of exhibiting osteophytes involving the sella turcica, thereby, the shape of the skull, age, and sex partially explain the variations observed for the presence of sella turcica osteophytes.

PURPOSE: There is a common opinion that spinal fractures usually reflect the substantial impact of injuries and therefore may be used as a marker of significant associated injuries, specifically for intra-abdominal injury (IAI). The impact of concomitant spinal cord injury (SCI) with the risk of associated IAI has not been well clarified. The aim of this study was to evaluate the incidence and severity of IAIs in patients suffering from spinal fractures with or without SCI. METHODS: A retrospective cohort study using the Israeli National Trauma Registry was conducted. Patients with thoracic, lumbar and thoracolumbar fractures resulting from blunt mechanisms of injury from January 1, 1997 to December 31, 2018 were examined, comparing the incidence, severity and mortality of IAIs in patients with or without SCI. The collected variables included age, gender, mechanism of injury, incidence and severity of the concomitant IAIs and pelvic fractures, abbreviated injury scale, injury severity score, and mortality. Statistical analysis was performed using GraphPad InStat ® Version 3.10, with Chi-square test for independence and two sided Fisher's exact probability test. RESULTS: Review of the Israeli National Trauma Database revealed a total of 16,878 patients with spinal fractures. Combined thoracic and lumbar fractures were observed in 1272 patients (7.5%), isolated thoracic fractures in 4967 patients (29.4%) and isolated lumbar fractures in 10,639 patients (63.0%). The incidence of concomitant SCI was found in 4.95% (63/1272), 7.65% (380/4967) and 2.50% (266/10639) of these patients, respectively. The overall mortality was 2.5%, proving higher among isolated thoracic fracture patient than among isolated lumbar fracture counterparts (11.3% vs. 4.6%, p < 0.001). Isolated thoracic fractures with SCI were significantly more likely to die than non-SCI counterparts (8.2% vs. 3.1%, p < 0.001). There were no differences in the incidence of IAIs between patients with or without SCI following thoracolumbar fractures overall or in isolated thoracic fractures; although isolated lumbar fractures patients with SCI were more likely to have renal (3.4% vs. 1.6%, p = 0.02) or bowel injuries (2.3% vs. 1.0%, p = 0.04) than the non-SCI counterparts. CONCLUSION SCI in the setting of thoracolumbar fracture does not appear to be a marker for associated IAI. However, in a subset of isolated lumbar fractures, SCI patient is associated with increased risks for renal and bowel injury.