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Journal of Osteoporosis
Volume 2010 (2010), Article ID 504078, 5 pages
Research Article

Bone Density and Cortical Thickness in Normal, Osteopenic, and Osteoporotic Sacra

International Center for Orthopaedic Advancement, Department of Orthopaedic Surgery, The Johns Hopkins Bayview Medical Center, 3rd Floor, Alpha Center, 5210 Eastern Avenue, Baltimore, MD 21224-2780, USA

Received 19 June 2009; Revised 9 September 2009; Accepted 20 March 2010

Academic Editor: Joseph Michael Lane

Copyright © 2010 Andrew M. Richards et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


It is unclear if a decrease in cancellous bone density or cortical bone thickness is related to sacral insufficiency fractures. We hypothesized that reduction in overall bone density leads to local reductions in bone density and cortical thickness in cadaveric sacra that match clinically observed fracture patterns in patients with sacral insufficiency fractures. We used quantitative computed tomography to measure cancellous density and cortical thickness in multiple areas of normal, osteopenic, and osteoporotic sacra. Cancellous bone density was significantly lower in osteoporotic specimens in the central and anterior regions of the sacral ala compared with other regions of these specimens. Cortical thickness decreased uniformly in all regions of osteopenic and osteoporotic specimens. These results support our hypothesis that areas of the sacrum where sacral insufficiency fractures often occur have significantly larger decreases in cancellous bone density; however, they do not support the hypothesis that these areas have local reduction of cortical bone thickness.