ArticleJournal of Korean Neurosurgical Society2021
Is the Spinal Instability Neoplastic Score Accurate and Reliable in Predicting Vertebral Compression Fractures for Spinal Metastasis? A Systematic Review and Qualitative Analysis.
Article in Journal of Korean Neurosurgical Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- The Conundrum of Spinal Metastases-A Review of Current Management.Journal of clinical medicine · 2025Review
- Biomechanical effects of defect size and location on vertebral fracture.Journal of medical and biological engineering · 2025Article
- Spinal Instability Neoplastic Score as a Predictor of Vertebral Fracture in Patients Undergoing Radiation Therapy for Spinal Metastases: A Single-Institution Study.Advances in radiation oncology · 2025Article
- What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate?Global spine journal · 2025Article
- Article
- An Updated Review on the Treatment Strategy for Spinal Metastasis from the Spine Surgeon's Perspective.Asian spine journal · 2022Article
- 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
- Treatment Strategy for Metastatic Spinal Tumors: A Narrative Review.Asian spine journal · 2020Article
- Changes in Spinal Instability After Conventional Radiotherapy for Painful Vertebral Bone Metastases.Cancer control : journal of the Moffitt Cancer CenterArticle
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Authors and funding
8 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Spinal metastases can present with varying degrees of mechanical instability. The Spinal Instability Neoplastic Score (SINS) was developed as a tool to assess spinal neoplastic-related instability while helping to guide referrals among oncology specialists. Some previous papers suggested that the SINS was accurate and reliable, while others disagreed with this opinion. We performed a systematic review regarding the SINS to evaluate its accuracy and precision in predicting vertebral compression fractures (VCFs). The 21 included studies investigated a total of 2118 patients. Thirteen studies dealt with the accuracy of SINS to predict postradiotherapy VCFs, and eight dealt with the precision. Among 13 studies, 11 agreed that the SINS categories showed statistically significant accuracy in predicting VCF. Among eight studies, body collapse was effective for predicting VCFs in six studies, and alignment and bone lesion in two studies. Location has no statistical significance in predicting VCFs in any of the eight studies. The precision of SINS categories was substantial to excellent in six of eight studies. Among the six components of the SINS, the majority of the included studies reported that location showed near perfect agreement; body collapse, alignment, and posterolateral involvement showed moderate agreement; and bone lesion showed fair agreement. Bone lesion showed significant accuracy in predicting VCFs in half of eight studies, but displayed fair reliability in five of seven studies. Although location was indicated as having near perfect reliability, the component showed no accuracy for predicting VCFs in any of the studies and deleting or modifying the item needs to be considered. The SINS system may be accurate and reliable in predicting the occurrence of postradiotherapy VCFs for spinal metastasis. Some components seem to be substantially weak and need to be revised.
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