Background: Computed tomography (CT) can be used to accurately determine bone density in Hounsfield units (HU), the use of CT as a predictive tool has not been conclusively demonstrated in relation to low energy vertebra compression fracture (VCF).The aim of this study was to define the CT parameters that could be used to predict the risk of VCF. Materials and Methods:One hundred consecutive patients undergoing CT scans were enrolled in this study. Bone density measurements were obtained at the T10-L5 levels from the cancellous portion of the vertebral body in the mid-sagittal, mid-coronal and axial planes. The presence of a single-level or multi-level VCF was identified by CT. Multi-level degenerative changes were characterized and recorded. Logistic regression was utilized to assess the relationship between the variables of bone density in HU, single-or multi-level VCF and the presence of degenerative changes.Results: HU were found to have a strong correlation to the risk of VCF. HU of less than 101 were associated with a significant increase in the rate of VCF, whereas HU of less than 82 were associated with a significant increase in the rate of multilevel VCF. Hypertrophic degenerative changes were found to be associated with a decreased rate of VCF. Conclusion:CT data can accurately define the risk of VCF and therefore presents a useful clinical tool to support the need for prophylactic medical therapies for osteoporosis or to provide information useful in counseling patients at risk for VCF.