Failure strength of human vertebrae: Prediction using bone mineral density measured by DXA and bone volume by micro-CT

► Vertebral BMC and BMD from lateral-projection DXA better predict BV and BV/TV from μCT, compared to PA-projection DXA. ► Vertebral BMC and BMD from lateral-projection DXA better predict failure load determined experimentally, compared to PA-projection DXA. ► BVtot measured by μCT is the best predictor of vertebral failure load determined experimentally. ► In conclusion, lateral-projection DXA has greater capability than PA-projection DXA to predict variations in vertebral bone quantity and strength. ► This provides basis for further exploring the clinical application of lateral-projection DXA analysis.