ArticleSpinal cord2020
The clinical utility of the Spinal Instability Neoplastic Score (SINS) system in spinal epidural metastases: a retrospective study.
Article in Spinal cord, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 23 citations in OpenAlex.
- How to select a treatment method for patients with potentially unstable metastatic vertebrae (spinal instability neoplastic score 7-12): a systematic review.Asian spine journal · 2026Article
- The significance of adding posterior decompression to spine stabilization in metastatic spinal surgery: a multicenter prospective study.Scientific reports · 2025Article
- Can we predict neurological complications in patients with metastatic spinal tumors?Frontiers in oncology · 2025Article
- Role of Decompressive Surgery in Neurologically Intact Patients with Low to Intermediate Intraspinal Metastatic Tumor Burden.Cancers · 2023Article
- Palliative radiotherapy of bone metastases in octogenarians: How do the oldest olds respond? Results from a tertiary cancer center with 288 treated patients.Radiation oncology (London, England) · 2022Article
- Ten Years After SINS: Role of Surgery and Radiotherapy in the Management of Patients With Vertebral Metastases.Frontiers in oncology · 2022Review
- Treatment Strategy for Metastatic Spinal Tumors: A Narrative Review.Asian spine journal · 2020Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designA retrospective study.
objectivesThis study assessed the clinical utility of the Spinal Instability Neoplastic Score (SINS) in relation to the surgical treatment of spinal epidural metastasis and factors important for surgical decision-making. These factors include epidural spinal cord compression (ESCC), patient prognosis and neurologic status.
settingQueen Elizabeth II Health Sciences Centre, Halifax, Canada.
methodsWe identified 285 patients with spinal metastatic disease. Data were extracted through a retrospective review. SINS and ESCC were scored based on CT and MRI, respectively.
resultsPatients were grouped into stable (35%), potentially unstable (52%), and unstable (13%) groups. The overall incidence of metastatic spinal deformity was 9%. Surgical interventions were performed in 21% of patients, including decompression and instrumented fusion (70%), decompression alone (17%), percutaneous vertebral augmentation (9%), and instrumented vertebral augmentation (5%). The use of spinal instrumentation was significantly associated with unstable SINS (p = 0.005). Grade 3 ESCC was also significantly associated with unstable SINS (p < 0.001). Kaplan-Meier analysis revealed that SINS was not a predictor of survival (p = 0.98). In the radiotherapy-alone group, a significant proportion of patients with potentially unstable SINS (30%) progressed into unstable SINS category at an average 364 ± 244 days (p < 0.001).
conclusionThis study demonstrated that more severe categories of SINS were associated with higher degrees of ESCC, and surgical interventions were more often utilized in this group with more frequent placement of spinal instrumentation. Although SINS did not predict patient prognosis, it correlates with the progression of metastatic instability in patients treated with radiotherapy.
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