Component scores for clinical and radiographic findings | Score | |
Spine 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 | |
Pain relief with recumbence (lying down) or pain with movement/loading of the spine | ||
Yes | 3 | |
No (occasional pain but not mechanical) | 1 | |
Pain-free lesion | 0 | |
Bone lesion quality | ||
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 elements (facet, pedicle, or costovertebral joint fracture or replacement with tumor) | ||
Bilateral | 3 | |
Unilateral | 1 | |
None of the above | 0 | |
The SINS score is generated by adding all of the scores from the six individual components (minimal score is 0, maximal score is 18) | ||
Score | Classification | Action |
0 to 6 | Stable spine | |
7 to 12 | Indeterminant | Possible impending instability, warrants surgical consultation |
13 to 18 | Instability | Warrants surgical consultation |
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