Orthopedic & Spine Surgeons

You planned for bone that would hold.

You’ve felt it mid-case: the screw that spins instead of biting, the vertebra that gives under the tap, the pedicle that won’t take purchase. The imaging didn’t warn you. Now you’re improvising — reaching for cement, extending the construct, or accepting a fixation you wouldn’t have chosen.

Bone density is answering a different question than the one you’re asking.

You’re asking a mechanical question. DXA gives you a mineral count. It measures how much mineral is present. And in the degenerated spines you operate on, it’s an unreliable guide to whether the bone will hold your hardware.

And it’s least reliable in exactly the patients you operate on. Lumbar DXA can’t tell bone from bone spurs — osteophytes, facet arthrosis, and aortic calcification all add to the reading without adding any strength. The degeneration that brought the patient to you is the same thing inflating their T-score.

Bring BoneScore to your practice →

Density isn’t holding power.

You’re asking a mechanical question. DXA gives you a mineral count.

DXA is confounded in the spines you operate on.

Osteophytes and sclerosis inflate lumbar DXA, so it’s an unreliable guide to fixation — and CT Hounsfield units now outperform it for judging the bone that has to hold your hardware.1,2

Fixation is a material-property problem.

Screw purchase, pullout resistance, and subsidence depend on the bone’s toughness and resistance to crack propagation at the interface — not on how much mineral is present. Fixation depends on the bone’s material properties — not its mineral count.

That’s what BoneScore measures.

OsteoProbe presses a probe into the bone and reads how the tissue resists — the same class of mechanical behavior that governs fixation. In laboratory studies, BMSi correlates with bone toughness and whole-bone strength.3,4

R ≈ 0.57 — reference-point indentation, the principle behind BoneScore, tracked maximum screw torque in cadaveric bone.5

A pre-operative bone-quality data point.

OsteoProbe® measures bone material strength (BMSi). Used pre-op, it gives you an objective read before you’re committed to a plan — one input to the conversations you’re already having:
  • Cemented vs. cementless
  • Augmentation and biologic use
  • Hardware selection and construct design
  • Whether to optimize bone health before elective surgery
  • Whether this patient warrants a longer or different fixation strategy

It fits inside the appointment you already booked.

  • Performed by your RN
  • No radiation, no prep, no sedation, no recovery
  • Well-tolerated — pain scores at or below 1 of 10 in formal studies
  • CPT III code 0547T issued; coverage currently case-by-case
Scope: OsteoProbe is currently cleared for measurement at the tibia in an office setting. An operating-room–compatible device is in development. Today’s use case is pre-operative assessment — not intraoperative measurement.
Add BoneScore to your practice →

BMSi adds one objective, radiation-free bone-quality data point; OsteoProbe is not cleared to predict fixation or surgical outcomes.

References

  1. Zaidi Q, et al. Measurement techniques and utility of Hounsfield unit values for assessment of bone quality prior to spinal instrumentation. 2022. View source →
  2. The Spine Journal. Review of DXA limitations in the degenerative lumbar spine. 2021. View source →
  3. Gallant MA, Burr DB, et al. Reference-point indentation correlates with bone toughness and material properties. 2013. View source →
  4. Vaidya RS, et al. Impact microindentation evaluates bone strength, bone quality, and fracture susceptibility across skeletal sites: a cadaver study. Clinical Orthopaedics and Related Research. 2026 (accepted). View source →
  5. McAndrew CM, et al. Reference-point indentation and maximum insertional screw torque in cadaveric bone. 2018. View source →
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