Table 3.
SINS score. Recommendation TS >= 7: Consider surgical intervention.
| Component | Score |
|---|---|
| Location | |
| Junctional (O-C2; C7-T2; T11-L1; L5-S1) | 3 |
| Mobile spine (C3-6; L2-4) | 2 |
| Semirigid (T3-T10) | 1 |
| Rigid (S2-S5) | 0 |
| Mechanical pain* | |
| Yes | 3 |
| No | 2 |
| Pain free lesion | 1 |
| Bone Lesion | |
| Lytic | 2 |
| Mixed (lytic/blastic) | 1 |
| Blastic | 0 |
| Radiographic spinal alignment | |
| Subluxation/translation present | 4 |
| Deformity (kyphosis/scoliosis) | 2 |
| Normal | 0 |
| Vertebral body collapse | |
| >50% collapse | 3 |
| <50% collapse | 2 |
| No collapse with >50% body involved | 1 |
| None of the above | 0 |
| Posterolateral involvement± | |
| Bilateral | 3 |
| Unilateral | 1 |
| None of the above | 0 |
| Criteria of instability | |
| Total score (TS) 0–6 | Stable |
| Total score (TS) 7–11 | Potential unstable |
| Total score (TS) 12–18 | Unstable |
*
Pain improvement with recumbency and/or pain with movement/loading of the spine.
±
Facet, pedicle, joint fracture or replacement with tumor [38].