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Clinical Application of Spine Trabecular Bone Score (TBS)

  • Assessment of bone health
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Clinical Reviews in Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Trabecular bone score (TBS) is a software program recently approved by the US Food and Drug Administration for post-acquisition processing of lumbar spine dual-energy X-ray absorptiometry images that allows assessment of bone texture as a surrogate for bone microarchitecture. Low TBS values are associated with increased risk of major osteoporotic fracture risk in postmenopausal women and men aged 40 years and older independent of BMD. TBS data can be used to adjust FRAX probability of fracture. As such, TBS data can be useful in osteoporosis treatment initiation decisions. Following treatment initiation, TBS increases are smaller than seen with BMD; at present, there is insufficient evidence that TBS can be used to monitor treatment. TBS may be particularly helpful in fracture risk prediction for those with diabetes mellitus or receiving glucocorticoid therapy, but additional validation of existing observations is needed. In summary, TBS should not be used alone to guide treatment initiation, but can be used with FRAX to estimate fracture probability in postmenopausal women and older men, thereby facilitating treatment initiation decisions.

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Both NB and WDL made substantial contributions to the conception and drafting/revising and have approved the final version of this manuscript.

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  1. Department of Medicine; Divisions of Geriatrics and Endocrinology, University of Wisconsin, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA

    Neil Binkley

  2. Department of Medicine (C5121), University of Manitoba, 409 Tache Avenue, Winnipeg, R2H 2A6, Canada

    William D. Leslie

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Correspondence to Neil Binkley.

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Neil Binkley has received research grants from Amgen, Eli Lilly, GE Healthcare, Merck and Opko Ireland and serves as a consultant or on advisory boards for Amgen, Astellas, Bristol-Myers Squibb, Eli Lilly and Merck. William D. Leslie (all fees paid to facility) has received speaker honorarium from Amgen, Eli Lilly, and Novartis and research grants from Amgen.

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Binkley, N., Leslie, W.D. Clinical Application of Spine Trabecular Bone Score (TBS). Clinic Rev Bone Miner Metab 14, 14–25 (2016). https://doi.org/10.1007/s12018-016-9203-7

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