ArticleAdvances in radiation oncology2025
Spinal Instability Neoplastic Score as a Predictor of Vertebral Fracture in Patients Undergoing Radiation Therapy for Spinal Metastases: A Single-Institution Study.
Article in Advances in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: The Spinal Instability Neoplastic Score (SINS) is the most common method of assessing spine stability in the setting of spinal metastases. We sought to assess (1) the SINS score as a predictor of vertebral compression fracture (VCF), (2) the risk contributions of the 6 SINS individual factors, and (3) other contributors to fracture risk. Methods and Materials: In total, 194 patients with 391 spinal lesions that had not previously been treated with vertebroplasty/kyphoplasty, radiation therapy (RT), or surgery were enrolled before RT and followed for new or worsened fracture. Results: A total of 187 patients who were treated to 361 vertebral levels underwent post-RT follow-up. Average follow-up time for patients on study was 9.4 months (range, 0.2-38.8 months). A total of 33 new or worsened fractures (9.1% of lesions followed) were observed, with an average time to fracture of 4.4 months (range, 0.1-27.8 months). Of all 6 SINS factors, 3 were found to be individually significantly associated with increased risk of fracture, these were: lesion location in L2-L4 [hazard ratio (HR) = 2.78, Conclusions: These findings support that SINS is a useful tool for estimating VCF risk, with lesion location, metastasis bone morphology, and presence of <50% collapse being the strongest predictors. Additionally, findings suggest that bone-strengthening medications such as bisphosphonates may mitigate the risk of developing VCF after RT.
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