tilou, trabecular bone score measures fracture risk in the lacy bone that is surrounded by the less flexible cortical bone. It is calculated by new(er) software using the same 2d images that dxa creates. https://onewelbeck.com/news/trabecular-bone-scoring/#:~:text=Trabecular%20Bone%20Score%20is%20a,is)%20which%20has%20several%20applications.
You may already know that because trabecular bone has more surface area it is more vulnerable to density loss. Vertebra have the most of this type of bone. Alignment of the spicules remodels for strength by aligning according to the pressures placed on it by our activities.
Fracture of this type of bone can be devastating because healing doesn't restore height lost
with vertebral compression.
Determining the strength of this bone with a trabecular bone score may prove to identify the risk of fracture in more individuals . https://study.com/academy/lesson/trabeculae-of-bone-definition-function.html#:~:text=Trabeculae%20are%20the%20thin%20columns,ribs%2C%20skull%2C%20and%20vertebrae.

Yes, more fractures happen in osteopenic women than in osteoporotic women. That is because there are far more osteopenic women than there are osteoporotic women.