Vertebral trabecular microarchitecture changes in the normally ageing population

This study demonstrates that vertebral trabecular microarchitecture undergoes significant age- and sex-specific changes that are detectable using clinical high-resolution computed tomography (CT). The identification of critical remodelling phases-particularly in men between 55-59 and 75-80 years-and the consistent sensitivity of D3D to sex differences highlight the value of CT-based architectural assessment. These findings suggest that routine abdominal CT, when enhanced with advanced reconstruction techniques, may serve as a useful tool for early detection of bone fragility and support individualized strategies for fracture risk assessment.