Table 4 Spine instability neoplastic score (SINS)^a

1. Location

 Junctional (O-C2; C7-T2; T11-L1; L5-S1)

3

 Mobile spine (C3-6; L2-4)

2

 Semirigid (T3-10)

1

 Rigid (S2-5)

0

2. Pain level

 Mechanical pain: improves with rest, exacerbated with movement

3

 Occasional pain but not mechanical

2

 Pain-free lesion

1

3. Bone lesion

 Lytic

2

 Mixed

1

 Blastic

0

4. Radiographic spinal alignment

 Subluxation/translation present

4

 Deformity (kyphosis/scoliosis)

2

 Normal

0

5. Vertebral body collapse

 > 50% collapse

3

 < 50% collapse

2

 No collapse with > 50% body involved

1

 None of the above

0

6. Posterolateral involvement

 Bilateral

3

 Unilateral

1

 None of the above

0