Resistance to vertebral fracture is provided by a bone structure that integrates the cortical shell, or cortex, with trabecular bone. The cortical shell of vertebral bodies demonstrates a contribution to load sharing that is disproportionate to its relative bone volume fraction, but there is a paucity of data on the bone quality of the cortex relative to the adjacent trabeculae. The aim of this project was to quantify the microdamage burden, mineralisation and microarchitecture of the cortical shell of the human L2 vertebra.