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. 2020 Jun 24;64(1):4–12. doi: 10.3340/jkns.2020.0105

Table 1.

Spinal Instability Neoplastic Score (SINS)

SINS component Score
Location
 Junctional (occiput-C2, C7–T2, T11–L1, L5–S1) 3
 Mobile segment (C3–C6, L2–L4) 2
 Semirigid (T3–T10) 1
 Rigid (S2–S5) 0
Pain
 Yes 3
 Occasional pain but not mechanical 1
 Pain-free lesion 0
Bone lesion
 Lytic 2
 Mixed (lytic/blastic) 1
 Blastic 0
Spinal alignment
 Subluxation/translation 4
 De novo deformity (kyphosis/scoliosis) 2
 Normal alignment 0
Body collapse
 >50% collapse 3
 <50% collapse 2
 No collapse with >50% body involved 1
 None of above 0
Posterolateral involvement of spinal elements
 Bilateral 3
 Unilateral 1
 None 0

Three categories (0 to 6, stable; 7 to 12, potentially unstable; and 13 to 18, unstable)