The Spinal Instability Neoplastic Score (SINS) can be used to evaluate spinal stability in a patient with a tumor involving the spine. It was developed by the Spine Oncology Study Group.
Parameters:
(1) location of tumor
(2) pain with movement and/or pain on spinal loading and/or pain relief with recumbency
(3) bone lesion
(4) spinal alignment on imaging studies
(5) collapse of vertebral body
(6) involvement of posterolateral spinal elements
|
Parameter |
Finding |
Points |
|
location of tumor |
occiput to T2 (junctional) |
3 |
|
|
C3 to C6 (mobile spine) |
2 |
|
|
C7 to T2 (junctional) |
3 |
|
|
T3 to T10 (semirigid) |
1 |
|
|
T11 to L1 (junctional) |
3 |
|
|
L2 to L4 (mobile spine) |
2 |
|
|
L5 to S1 (junctional) |
3 |
|
|
S2 to S5 (rigid) |
0 |
|
pain |
present, mechanical |
3 |
|
|
occasional but not mechanical |
1 |
|
|
none (pain free) |
0 |
|
bone lesion |
lytic |
2 |
|
|
lytic and blastic (mixed) |
1 |
|
|
blastic |
0 |
|
spinal alignment |
subluxation and/or translation present |
4 |
|
|
de novo deformity (kyphosis, scoliosis) |
2 |
|
|
normal |
0 |
|
collapse |
> 50% collapse |
3 |
|
|
<= 50% collapse |
2 |
|
|
> 50% of body involved without collapse |
1 |
|
|
other |
0 |
|
posterolateral spinal involvement |
bilateral |
3 |
|
|
unilateral |
1 |
|
|
none |
0 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 18
• The higher the score the greater the spinal instability.
|
Score |
Interpretation |
Management |
|
0 to 6 |
stable |
nonsurgical |
|
7 to 12 |
indeterminate (possible impending instability) |
consider surgical |
|
13 to 18 |
unstable |
consider surgical |
Specialty: Hematology Oncology, Surgery, general
ICD-10: ,
