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Updated: Aug 8, 2026
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Trabecular Bone Microarchitecture Evaluation in an Osteoporosis Mouse Model
Published on: September 8, 2023
Trabecular bone score beyond bone mineral density for identifying osteoporotic vertebral compression fractures: a
Rathapoom Suwanaratana1, Attaporn Lawanprasert1, Nuttawut Chanalithichai2,3
1Department of Orthopaedic Surgery, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
Asian Spine Journal
|August 6, 2026
Summary
Low trabecular bone score (TBS) helps identify vertebral fractures in patients with normal bone mineral density (BMD). Abdominal aortic calcification (AAC) may indicate bone-vascular health but its association with fractures is less clear.
Area of Science:
- Orthopedics
- Radiology
- Geriatrics
Background:
- Conventional bone mineral density (BMD) thresholds may not fully identify patients with vertebral skeletal fragility.
- Vertebral fractures can occur even with non-osteoporotic BMD.
- Trabecular bone score (TBS) assesses bone microarchitecture, complementing BMD, while abdominal aortic calcification (AAC) may indicate systemic bone-vascular health.
Purpose of the Study:
- To assess the discordance between bone mineral density (BMD) and trabecular bone score (TBS).
- To evaluate high-burden abdominal aortic calcification (AAC) in patients with osteoporotic vertebral compression fractures (OVCF).
Main Methods:
- Retrospective, sex- and age-matched case-control study.
- Included patients aged ≥50 years with dual-energy X-ray absorptiometry (DXA), TBS, and vertebral imaging.
- Analyzed BMD, TBS, and AAC-24 using conditional logistic regression.
Main Results:
- Over half of OVCF patients (53.2%) had non-osteoporotic BMD.
- Low TBS was more prevalent in OVCF cases with non-osteoporotic BMD (48.0% vs. 22.7%).
- Low TBS independently predicted OVCF (OR, 2.66; p=0.011), even after adjusting for BMD and high-burden AAC.
Conclusions:
- Low TBS can help identify vertebral skeletal fragility in OVCF patients with normal BMD on DXA.
- High-burden AAC may offer vascular insights, but its independent association with OVCF was attenuated.
