Understanding T Scores by vertebrae

Posted by hopeful12 @hopeful12, Jun 11 11:24pm

Hello.
I have bad osteoporosis of the spine. Hoping someone can explain how vertebrae T scores work - was grateful to find this website and recently joined.

My dexa scan report says "Lowest T Score: -3.5: AP Spine L1-L4".
T scores by vertebrae are L1 =-3.4, L2 = -4.5, L3= -3.7, L4 = -2.9. (I had to ask my doctor for the details by vertebrae).
My doctor said to just look at the total score of -3.5 and didn't clearly explain why. Does anyone know why? Shouldn't my worst vertebrae T-score of -4.5 at L2 be the score to assess the severity of my osteoporosis and treatment? I would think L2 would be at most risk of fracture.

Any insight would be appreciated.

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njx58 | @njx58 | Jun 12 7:07am

I am not sure it matters in your case because all of the scores unfortunately indicate severe osteoporosis. It's not like -3.5 is less concerning than -4.5. Either one requires immediate treatment.

oopsiedaisy | @oopsiedaisy | Jun 12 3:50pm

A calculation is performed for each vertebra, i.e., it's not just an average of all four T-scores measured by the DEXA. This is because the measured reference value for a young person is different for each vertebra. Your score is compared to this value for each vertebra and the standard deviation from the reference value is calculated. The resulting values are then averaged to provide the total T-score.