Vertebral fracture assessment (spine DEXA) Diagnostic Imaging

Vertebral fracture assessment (VFA) is a lateral image of the thoracic and lumbar spine taken with a bone density scanner called DXA.

Vertebral fracture assessment (spine DEXA) procedure illustration

Overview

Vertebral fracture assessment (VFA) is a lateral image of the thoracic and lumbar spine taken with a bone density scanner called DXA. It is used to look for compression fractures of the spine. Clinicians add VFA to a standard bone density test when there is concern for silent vertebral fractures. Finding these fractures can change fracture risk estimates and may affect treatment plans.

Overview Preparation Clinical Info Recovery FAQ References

Also known as: VFA, DXA vertebral fracture assessment, Lateral spine DXA

Recovery
Same day
Return to Work
Same day

Preparation & Next Steps

Everything you need to know before and after your procedure

Before Care

  • Wear loose, comfortable clothing without metal zippers, belts, or underwire if possible
  • Leave keys, phones, and jewelry out of the scan area to avoid image artifacts
  • Bring prior spine X-rays, CT or MRI reports, and any past DEXA results for comparison
  • Tell the imaging staff about recent barium studies, CT with contrast, or nuclear medicine tests
  • Inform the staff if there is any chance of pregnancy
  • Carry a current list of your medicines and supplements, including any steroids
  • Ask your center if they want you to avoid calcium supplements for 24 hours before testing
  • Arrive a bit early to complete check-in and safety questions
  • Arrange assistance if you have trouble lying flat or rolling onto your side

After Care

  • You can eat, drink, and return to normal activities right after the test
  • Review the report and images in your portal when available and keep a copy
  • Discuss the results with the ordering clinician, including whether any fractures were seen
  • Ask about how the findings may change your overall fracture risk assessment
  • If incidental findings are listed, ask whether any follow-up is needed
  • Contact a clinician promptly for severe back pain after a fall, new leg weakness or numbness, or loss of bladder or bowel control
  • Confirm if and when a future DEXA or VFA is suggested for monitoring

Clinical Information

Important medical details about this procedure

Indications

  • Osteoporosis screening or monitoring when vertebral fractures are suspected
  • Notable height loss or new rounded upper back posture
  • Back pain with concern for a compression fracture
  • Long-term glucocorticoid (steroid) use
  • Previous fragility fracture or very low bone density
  • High fracture risk based on clinical risk tools

Alternatives

  • Conventional lateral thoracic and lumbar spine X-rays
  • CT scan of the spine when more detail is needed
  • MRI if there are nerve or spinal cord concerns or to assess recent fractures
  • Clinical risk assessment tools such as FRAX without imaging

Risks

  • Very low radiation exposure
  • Limited detail compared with standard X-rays, which may miss or overcall mild changes
  • Discomfort from lying still on the table
  • Incidental findings that may lead to more tests
  • Not recommended during pregnancy unless clearly necessary

Contraindications

  • Known or possible pregnancy
  • Recent barium or nuclear medicine study that could obscure the spine image
  • Inability to lie flat or hold still for several minutes
  • Body size or weight beyond the scanner limits

Recovery Timeline

What to expect during your recovery

VFA is noninvasive and does not require recovery time. Most people resume normal activities immediately.

Typical Range

Same day

Return to Work

Same day

Recovery Milestones

Day 0

Leave the imaging center and resume normal daily activities

Day 0–2

Review results in your portal or with the ordering clinician

Day 1–14

Discuss any next steps such as additional imaging or treatment planning

Frequently Asked Questions

Common questions and expert answers about this procedure

What is vertebral fracture assessment?

It is a lateral image of your thoracic and lumbar spine taken with a DXA scanner to check for compression fractures.

How is VFA different from a standard bone density test?

A standard DXA measures bone density. VFA adds spine images during the same visit to look for vertebral fractures.

How long does VFA take?

It is usually added to the bone density appointment and takes only a few extra minutes. The full visit often lasts 10 to 30 minutes.

How much radiation is used?

DXA uses a very small amount of radiation, typically much less than standard spine X-rays.

Is VFA as detailed as regular spine X-rays?

No. VFA has lower image detail but can detect many compression fractures. Standard radiographs may be used if more detail is needed.

Will the test hurt or require needles or contrast?

No needles or contrast are used. You lie still on a padded table while the scanner takes images.

Who commonly gets VFA?

It is often ordered for people with risk factors such as height loss, long-term steroid use, prior fragility fracture, or low bone density.