It should be examined how far BMD semiquantitative (profile analysis) and qualitative datas (architecture of spongy bone, age of patient) can be combined in one score in order to improve the assessment of fracture risk. SE-QCT was performed in 220 patients with a mean age of 55.8 (33-84) years from whom conventional X-ray images of the thoracic and lumbar spine were available. In the axial scans spongiosa architecture was classified and a density profile analysis was carried out. This was followed by gradation of BMD values, different types of spongiosa architecture, profile analysis and age of patient to a numerical score. This was compared to the number of fractures, whereby the patients were separated into three groups: group I = no fracture, group II = one fracture, group III = more than one fracture. The BMD values, types of spongiosa architecture, semiquantitative profile analysis can be significantly assigned to the groups I and II (p < 0.02), groups I and III (p < 0.001), and the groups II and III (p < 0.05). By combining BMD values, architecture of spongy bone, density profile analysis, and age of patients without fracture, scale 8-12 = patients with or without fracture, scale 13-16 = patients with at least one fracture [corrected].