Table 4.
Spinal Instability Neoplastic Score system
| SINS component | Score |
|---|---|
| Location | |
| Junctional (occiput–C2, C7–T2, T11–L1, L5–S1) | 3 |
| Mobile spine (C3–C6, L2–L4) | 2 |
| Semi rigid (T3–T10) | 1 |
| Rigid (S2–S5) | 0 |
| Paina) | |
| Yes | 3 |
| Occasional pain but not mechanical | 1 |
| Pain-free lesion | 0 |
| Bone lesion | |
| Lytic | 2 |
| Mixed (lytic/blastic) | 1 |
| Blastic | 0 |
| Radiographic spinal alignment | |
| Subluxation/translation present | 4 |
| De novo deformity (kyphosis/scoliosis) | 2 |
| Normal alignment | 0 |
| Vertebral body collapse | |
| >50% collapse | 3 |
| <50% collapse | 2 |
| No collapse with >50% body involved | 1 |
| None of the above | 0 |
| Posterolateral involvement of spinal elementsb) | |
| Bilateral | 3 |
| Unilateral | 1 |
| None of the above | 0 |
SINS, Spinal Instability Neoplastic Score.
a)
Pain improvement with recumbency and/or pain with movement/loading of spine.
b)
Facet, pedicle, or costovertebral joint fracture or replacement with tumor.