The SINS score is a validated tool to help radiation oncologists and neurosurgeons decide when a tumor-involved spine requires rigid stabilization.
Anatomic Stability Probe
Complete the biomechanical audit by selecting the radiographic and clinical findings to determine the SINS stability profile.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Evaluating spine oncology patients (metastatic cancer) to determine the structural integrity of the spinal column.
Required metric before clearing a patient for stereotactic body radiation therapy (SBRT), as irradiating an unstable spine causes catastrophic collapse.
Section 2
Literature
Development
Developed by the Spine Oncology Study Group (SOSG) in 2010. Before this, "instability" in cancer patients was purely subjective, leading medical oncologists and radiation oncologists to repeatedly guess wrong, resulting in paralyzed patients. The SOSG identified the 6 radiographic and clinical features that accurately define when the structural column is compromised.
Section 3
Pearls/Pitfalls
Mechanical Pain
The presence of "mechanical pain" (pain that is absent at rest but agonizing upon standing, twisting, or weight-bearing) is the strongest clinical harbinger of instability and immediately yields 3 points. Radiographic appearance is secondary to this clinical finding.
Section 4
Evidence Appraisal
Primary Reference
A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group
Fisher CG et al. • Spine (Phila Pa 1976). 2010;35(22):E1221-9
