This Web site is not providing medical advice. The sole purpose of this section is to provide a general overview of VFA for patients and individuals who wish to improve their understanding of this technology: what it is, how it’s done and what the results mean. You should discuss your individual needs with your doctor or other healthcare provider. All medical decisions should be made by your doctor in consultation with you and any other relevant parties.
VFA stands for Vertebral Fracture Assessment. This is a test that looks at the individual bones in your back, called vertebral bodies, to see if any of them have an abnormal shape. If the height of one of these bones is less than expected, it could be due to a vertebral fracture. This may be the result of osteoporosis or an injury to the spine.
VFA is done on the same machine that measures your bone density to check for osteoporosis with dual-energy X-ray absorptiometry (DXA). This is a padded table with a movable arm that scans your bones with a very weak form of X-ray. It can be done on the same visit as measuring your bone density, as long as the technologist places you in the proper position for the VFA scan. It does not hurt. There are no shots or injections. If your clothes do not contain any metal, you may be able to leave them on.
If the results of the VFA are likely to make a difference in your medical care, then you should consider having it done. It is particularly useful if you are at high risk for vertebral fracture but do not know if you have one. If you have become shorter with age (more than 1.5 inches loss of height since your tallest), have stooped posture, previous fracture of any type as an adult, or unexplained back pain, you may have a vertebral fracture. A VFA can usually show whether or not there is a fracture.
Both are good tests to check for fractures in the spine. Standard X-rays give a sharper image of the bones than VFA, and can show the bones in the upper part of the spine better than VFA. On the other hand, VFA uses a much lower dose of X-ray, is less expensive, shows less distortion of the bones, and may be more convenient, since it can be done at the same time as the bone density test.
If you are found to have one or more vertebral fractures that were not previously recognized, it may change your diagnosis to osteoporosis, regardless of results on the bone density test, increase the prediction of future risk of fractures of all types, and result in a change in recommendations for treatment. Unlike other kinds of fractures, most vertebral fractures are not recognized until VFA or standard X-ray of the spine is done.
An elderly man with normal bone density has lost 3 inches in height since he got out of the military at the age of 25. A VFA scan showed a definite fracture in a vertebral body in the mid-portion of the spine. He had no known injury to explain the fracture. A diagnosis of osteoporosis was made, and he was started on medication to strengthen his bones and reduce the risk of future fractures.
The cost of VFA and insurance coverage for this test varies according to your geographic location (where you live) and your health plan. It is almost always less expensive than standard spine X-rays.
Dr. Paul G. Rochmis, MD
Last modified: June 10, 2014