The sacral body comprises the five fused sacral vertebral bodies forming the anterior curved surface of the sacrum. The upper surface of S1, the sacral promontory, forms the posterosuperior boundary of the pelvic inlet. The sacral bodies are separated anteriorly by four pairs of anterior sacral foramina through which the sacral nerve roots exit.
The sacral body is a common site of insufficiency fractures in osteoporotic patients, particularly in the sacral ala adjacent to the sacroiliac joint (Denis zone 1 and 2). The H-sign on MRI (bilateral ala fractures connected by a transverse body fracture) is pathognomonic. Sacroplasty (cement augmentation) stabilises osteoporotic sacral fractures. The sacral body is also the site of sacral chordoma, the most common primary sacral tumour.
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