The clinical utility of the Spinal Instability Neoplastic Score (SINS) system in spinal epidural metastases: a retrospective study

Study design A retrospective study. Objectives This 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...

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Bibliographic Details
Published in:Spinal cord 2020-08, Vol.58 (8), p.892-899
Main Authors: Dakson, Ayoub, Leck, Erika, Brandman, David M., Christie, Sean D.
Format: Article
Language:English
Subjects:
692/308/174
692/308/409
Anatomy
Augmentation
Biomedical and Life Sciences
Biomedicine
Clinical decision making
Compression
Decision making
Decompression
Epidural
Human Physiology
Identification methods
Instability
Instrumentation
Instruments
Magnetic resonance imaging
Medical prognosis
Metastases
Metastasis
Neurochemistry
Neuropsychology
Neurosciences
Patients
Prognosis
Radiation therapy
Spinal cord
Stability
Stability analysis
Vertebrae
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Summary:Study design A retrospective study. Objectives This 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. Setting Queen Elizabeth II Health Sciences Centre, Halifax, Canada. Methods We 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. Results Patients 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  
ISSN:1362-4393
1476-5624
DOI:10.1038/s41393-020-0432-8