Comparison of two widely used scoring systems for spinal metastases.
| Feature | Tokuhashi score | Spinal Instability Neoplastic Score (SINS) |
|---|---|---|
| Purpose | Predicts life expectancy in patients with spinal metastases | Assesses spinal stability in neoplastic disease |
| Clinical use | Guides surgical vs. conservative treatment decisions | Determines need for surgical stabilization or referral |
| Scoring range | 0–15 points | 0–18 points |
| Key parameters | - General condition- Number of extraspinal bone metastases- Number of vertebral metastases- Metastases to major organs- Primary tumor type- Neurological status | - Location of lesion- Pain characteristics- Bone lesion type- Spinal alignment- Vertebral body collapse- Posterolateral involvement |
| Interpretation | 0–8: predicted survival generally < 6 months (conservative or palliative management usually considered)9–11: predicted survival approximately 6–12 months (selected patients may be considered for surgery)12–15: predicted survival > 1 year (surgical treatment may be appropriate in suitable candidates) | 0–6: stable7–12: indeterminate13–18: unstable |
| Strengths | Prognostic clarity for survival-based decisions | Objective assessment of mechanical instability |
| Limitations | Less emphasis on mechanical factors | Does not predict survival |
| Developed by | Tokuhashi et al., Japan | Spine Oncology Study Group |
| Year introduced | 1990 (updated 2005) | 2010 |
OA: Conceptualization, Investigation, Formal analysis, Writing—original draft, Data curation, Writing—review & editing. M Subih: Conceptualization, Investigation, Formal analysis, Writing—original draft, Data curation, Writing—review & editing. LS: Conceptualization, Investigation, Formal analysis, Writing—original draft. M Stublla: Conceptualization, Investigation, Formal analysis, Writing—original draft, Data curation, Writing—review & editing. DB: Writing—review & editing. PT: Conceptualization, Investigation, Formal analysis, Writing—original draft, Data curation, Writing—review & editing. OS: Writing—review & editing. AEEAE: Writing—review & editing. All authors read and approved the submitted version.
Patricia Tai, who is the Editorial Board Member and Guest Editor of Exploration of Medicine, and Omar Alqaisi, who is the Guest Editor of Exploration of Medicine, had no involvement in the decision-making or the review process of this manuscript. The other authors declare no conflicts of interest.
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