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DEXA Scan
Vertebral Fracture Assessment (VFA)
A low-dose side-on image of the spine taken on the DEXA machine to spot vertebral fractures.
For information only — not medical advice. The content on this page is patient education to help you understand a condition or treatment. It is not a substitute for personalised assessment by a qualified clinician. Always consult your doctor or specialist about your own symptoms, diagnosis, and treatment decisions.
What it is
Vertebral fracture assessment (VFA) is a side-on image of the spine captured on the same DEXA machine used to measure bone density. Its purpose is to look for vertebrae that have partly collapsed — vertebral compression fractures — which are a key sign of osteoporosis. Many such fractures cause little or no pain and go unnoticed, so VFA is a way of finding them as part of a bone-health assessment.
How it works
Using the DEXA scanner's low-dose X-rays, a full side-on picture of the spine is taken so that the shape and height of each vertebra can be seen. A healthy vertebra has a fairly even, box-like shape; a fractured one has lost height, often at the front, giving a wedged or flattened appearance. The heights can be measured and graded to judge whether a fracture is present and how severe it is. Because it is done on the DEXA machine, the radiation dose is far lower than a conventional spinal X-ray.
What to expect
VFA is usually done at the same visit as your bone-density DEXA, so there is little extra to it. You lie on the table, sometimes on your side or with the scanning arm angled, and keep still while the side-on image is captured. It is quick and painless, adds only a small amount to the appointment, and involves only a very low dose of radiation.
Why it matters for spinal investigations
A previous vertebral fracture is one of the strongest indicators that further fractures may follow, yet many are silent and undetected. Finding one on VFA can significantly change the assessment of a person's fracture risk and the case for bone-strengthening treatment. Combining density measurement with a look for existing fractures gives a fuller picture of spinal bone health than either alone.
References & further reading
- —National Osteoporosis Guideline Group (NOGG) — Clinical Guideline for the Prevention and Treatment of Osteoporosis
- —Royal Osteoporosis Society — Clinical Guidance
- —International Society for Clinical Densitometry (ISCD) — Official Positions
This information is for general patient education and is not a substitute for an individual consultation. Always seek personalised advice from a qualified spinal specialist.
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