Texture Research Imaging Platform applies trabecular bone score (TBS) measurement principles to images acquired with multiple modalities to assess bone texture at various skeletal sites. This study aimed to assess the bone texture score in dual-energy X-ray absorptiometry-acquired lateral vertebral fracture assessment (VFA) images (BTS_VFA), evaluate its reproducibility, and vertebral fracture discrimination ability. Subjects included 178 VF cases and 178 non-VF controls, 136 women and 42 men in each group, age 55–92 years, from two research centers. Cases and controls were matched for age (±5 years), body mass index (±5 kg/m²) and TBS. All participants underwent dual-energy X-ray absorptiometry TBS assessment from standard posterior-anterior lumbar spine scans and BTS_VFA assessment. VF presence was determined using VFA images applying the Genant's method. BTS_VFA was lower among fractured women compared to non-fractured (0.626 ± 0.109 vs 0.675 ± 0.099, p < 0.01), but not among men. In a binary logistic regression adjusted for study center and sex, for each SD lower BTS_VFA, there was a 40% increase (OR 1.40, 95% CI (1.13–1.74)) in the risk of having a prevalent VF; area under the curve (95% CI) 0.616 (0.557–0.675). Inter-assessor and inter-centers ICCs for BTS_VFA measurements were very good; 0.96 (0.64–0.99) and 0.98 (0.95–0.99), respectively. The BTS_VFA precision (coefficient of variation) was 2.42%. This feasibility study demonstrates the potential to assess trabecular bone texture in lateral VFA images with good reproducibility. BTS_VFA can discriminate between fractured and non-fractured women independent of their age, body mass index and TBS. In conclusion, BTS_VFA, a potential trabecular texture assessment that excludes the posterior elements, may have value in fracture prediction or as a novel approach to be further investigated in spine surgery planning.

纹理研究成像平台将小梁骨评分 (TBS) 测量原理应用于通过多种模式获取的图像，以评估不同骨骼部位的骨骼纹理。本研究旨在评估双能 X 射线骨密度测定法获得的侧向椎体骨折评估 (VFA) 图像 (BTS _VFA ) 中的骨骼纹理评分，评估其再现性和椎体骨折辨别能力。受试者包括来自两个研究中心的 178 例 VF 病例和 178 例非 VF 对照，每组 136 名女性和 42 名男性，年龄在 55-92 岁之间。病例和对照的年龄（±5 岁）、体重指数（±5 kg/m ² ）和 TBS 相匹配。所有参与者都接受了标准后-前腰椎扫描和 BTS 的双能 X 射线骨密度法 TBS 评估_VFA评估。使用 Genant 方法使用 VFA 图像确定 VF 存在。与未骨折的女性相比，骨折女性的BTS _VFA较低（0.626 ± 0.109 对 0.675 ± 0.099，p < 0.01），但男性则不然。在针对研究中心和性别调整的二元逻辑回归中，对于每个 SD 较低的 BTS _VFA，患有普遍性 VF 的风险增加 40%（OR 1.40，95% CI (1.13–1.74)）；曲线下面积 (95% CI) 0.616 (0.557–0.675)。_{BTS VFA}测量的评估员间和中心间 ICC非常好；分别为 0.96 (0.64–0.99) 和 0.98 (0.95–0.99)。防弹_{少年团 VFA}精确度（变异系数）为 2.42%。该可行性研究展示了评估侧向 V​​FA 图像中的小梁骨纹理的潜力，具有良好的重现性。BTS _VFA可以区分骨折和未骨折的女性，而不受年龄、体重指数和 TBS 的影响。总之，BTS _VFA是一种排除后部元素的潜在小梁结构评估，可能在骨折预测中具有价值，或者作为一种新方法在脊柱手术计划中有待进一步研究。