Update on trabecular bone score

Abstract

Trabecular bone score (TBS) is an indirect and noninvasive measure of bone quality. A low TBS indicates degraded bone microarchitecture, predicts osteoporotic fracture, and is partially independent of clinical risk factors and bone mineral density (BMD). There is substantial evidence supporting the use of TBS to assess vertebral, hip, and major osteoporotic fracture risk in postmenopausal women, as well as to assess hip and major osteoporotic fracture risk in men aged > 50 years. TBS complements BMD information and can be used to adjust the FRAX (Fracture Risk Assessment) score to improve risk stratification. While TBS should not be used to monitor antiresorptive therapy, it may be potentially useful for monitoring anabolic therapy. There is also a growing body of evidence indicating that TBS is particularly useful as an adjunct to BMD for fracture risk assessment in conditions associated with increased fracture risk, such as type-2 diabetes, chronic corticosteroid excess, and other conditions wherein BMD readings are often misleading. The interference of abdominal soft tissue thickness (STT) on TBS should also be considered when interpreting these findings because image noise can impact TBS evaluation. A new TBS software version based on an algorithm that accounts for STT rather than BMI seems to correct this technical limitation and is under development. In this paper, we review the current state of TBS, its technical aspects, and its evolving role in the assessment and management of several clinical conditions.

Bone Health Status in Individuals with Amyotrophic Lateral Sclerosis: A Cross-Sectional Study on the Role of the Trabecular Bone Score and Its Implications in Neurorehabilitation

“…In fact, BMD is globally used as a valid technique to evaluate fracture risk; however, it is inexact in explaining why a person's bones fracture and others' do not. On the other hand, the TBS allows one to define individuals whose BMD is above the osteoporotic range as persons at higher risk of fractures [23]. More in detail, nearly normal or osteopenic bone (therefore, with a low risk of pathological fractures) may hide qualitative alterations in the trabecular structure (assessed only using the TBS), with a higher risk of fractures.…”

The Influence of the Mediterranean Dietary Pattern on Osteoporosis and Sarcopenia

“…Another useful tool is the Trabecular Bons Score (TBS), which, unlike DXA, which gives information on the cortical gap and provides information on the state of the trabecular bone. This technique complements DXA in the diagnosis of OP; according to its score, the bone microarchitecture can be classified into a TBS ≥ 1.31, which corresponds to normal microarchitecture, a TBS of 1.23–1.31, which corresponds to partially degraded microarchitecture and a TBS < 1.23, which responds to degraded microarchitecture [ 35 , 36 , 37 ]. Occasionally, some studies have broadened the BMD analysis with the volumetric parameter bone mineral density (vBMD) (total, trabecular and cortical bone density) for distinguishing trabecular from cortical bone.…”

Age and sex are excellent predictors of bone complications in patients with type 2 diabetes with no history of osteoporotic fracture or treatment for osteoporosis

“…[15][16][17][18] Although TBS is an indicator of bone quality, the values obtained from DXA scans of the lumbar spine are closely associated with the quality of the bone microarchitecture and provide additional information to BMD. [19][20][21] Indeed, low TBS has been shown to be associated with fracture in patients with T2DM. [22][23][24] Therefore, in the present study, we aimed to identify patients with T2DM with no history of osteoporotic fracture or osteoporosis treatment who are at risk of bone complications by assessing their bone quality and quantity.…”