PURPOSE: To compare the accuracy of lateral radiography of the spine with that of morphometric X-rayabsorptiometry(MXA) in vertebral morphometry, and to evaluate normal vertebral morphometry using MXA in Koreanwomen. MATERIALS AND METHODS: A spine phantom was constructed using copper pipe. Its anterior and posteriorheights were measured directly, with lateral radiographs and with MXA, and the values thus obtained were compared.Inter -and intra -observer variations were evaluated by three radiologists. The vertebral morphometry of 30 youngwomen volunteers were imaged using thoracic and lumbar lateral radiographs and MXA, and analysis included themeasurement of anterior and posterior heights from T4 to L4. We also obtained the vertebral morphometry of 200normal Korean women who underwent MXA between March 1995 and February 1996, though those with osteoporosis andother spinal lesions were excluded from this study. Thoracolumbar vertebral indexes were statistically correlatedwith age, height and bone mineral. RESULTS: There were no statistically significant differences in the heights ofspine phantom measured by MXA compared with actual size (mean difference=0.28mm). Simple radiographs weremagnified by 23.7% at a phantom-table distance of 15cm, and distortion ranged from 0.5% to 22.5%, depending onphantom level and phantom-table distance. In the study of volunteers, the magnification rate between a simpleradiograph and MXA was about 26.6%. Anterior height increased progressively from the thoracic to the lumbar spine,though posterior height peaked at L2, and L4 was less than anterior height. In Korean women, indices of vertebralmorphometry decreased significantly with aging, with the most prominent decrease occurring during the seventhdecade. The mineral density of spinal bone decreased markedly after the sixth decade. CONCLUSION: Radiographsshowed more magnification and distortion than did MXA, though between morphometric X-ray absorptiometry (MXA) andactual size, there was no significant difference. The vertebral morphometric indices of Korean women and referredbone mineral density may provide useful data for determining and evaluating follow-up changes in spinalmorphology.