What Is A Trabecular Bone Score?
Today I want to talk briefly about your Trabecular Bone Score (TBS). If you have osteoporosis or osteopenia, be sure to understand what this score is before you schedule your next DEXA scan
You probably already know that your DEXA scan and the resulting T score don't give you the full picture of your bone health. It is a score of bone density and doesn't give you a lot of information about your fragility.
The next step in figuring out your risk of fracture is your Trabecular Bone Score.
Anatomy first. You have two types of bone, cortical and trabecular.
Cortical bone is the hard, outer part of your bone, it is dense and compact.
The trabecular bone is the inner bone. It is honeycomb-like and filled with marrow and fat.
The TBS is calculated from the lumbar spine image in your DEXA scan. It is important to note that not all DEXA scans can give you the TBS value, as it is computed from a specific software program your imaging center has to have.
Getting a TBS can add to the bone health picture by helping to predict your risk of bone fracture. It takes information about the number and spacing characteristics of the trabecular bone and gives you a score.
While a high TBS number indicates strong inner bone, a low TBS number is related to an increased risk of fracture. This is valuable because the DEXA scan alone may indicate very mild osteopenia or normal bone mass, while the inner bone may be more fragile.
Having two scores (the TBS and the DEXA) will give you a better picture of what is happening with both the cortical and trabecular bone. You can then add your medical history to the puzzle to help you determine how to proceed with getting stronger bones and eventually reducing your risk of fracture.
🔥When you schedule your next DEXA scan, ask if they will be giving you a TBS along with your t-score. If not, shop around for another DEXA scan machine that will give you this information.
I also recommend getting a DEXA scan before you turn 65. Women begin to lose bone rapidly at the menopause transition, and the average American women goes through the menopause transition at 51, so why wait almost 15 years to find out if you need to make significant lifestyle changes? Get your baseline!
I hope this is helpful. I have exercise tutorials on my YouTube channel to help inspire you to build bone with weight-bearing, fun, and effective techniques. Check them out, and be sure to subscribe.
As always, my references are listed below. You can read more in-depth if that is your thing - I gave you an overview here today.
To your healthy bones,
Andrea Trombley PT, DPT
References:
Harvey, N. C., Glüer, C. C., Binkley, N., McCloskey, E. V., Brandi, M. L., Cooper, C., Kendler, D., Lamy, O., Laslop, A., Camargos, B. M., Reginster, J. Y., Rizzoli, R., & Kanis, J. A. (2015). Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice. Bone, 78, 216–224. https://doi.org/10.1016/j.bone.2015.05.016
Sangondimath, G., Sen, R. K., & T, F. R. (2023). DEXA and Imaging in Osteoporosis. Indian journal of orthopaedics, 57(Suppl 1), 82–93. https://doi.org/10.1007/s43465-023-01059-2
Updated 10/16/24