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The Spinal Instability Neoplastic Score: Impact on Oncologic Decision-Making.
Anne L Versteeg1, Jorrit-Jan Verlaan1, Arjun Sahgal2
1Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Spine
|August 5, 2016
Summary
Before the Spinal Instability Neoplastic Score (SINS), spinal instability lacked clear definitions. SINS has improved reporting but its prognostic value remains debated.
Area of Science:
- Oncology
- Neurosurgery
- Radiology
- Orthopedics
Background:
- Spinal neoplastic instability lacked standardized definitions and assessment tools prior to 2010.
- The Spinal Instability Neoplastic Score (SINS) was introduced in 2010 to provide a consensus-based method for assessing spinal stability in neoplastic conditions.
Purpose of the Study:
- To systematically review the literature on spinal neoplastic instability definitions and classification before and after SINS introduction.
- To evaluate the impact of SINS on clinical practice and its potential as a prognostic tool.
Main Methods:
- A systematic literature review was conducted using PubMed, Embase, and clinical trial databases.
- Keywords included "spinal neoplasm," "spinal instability," and "Spinal Instability Neoplastic Score (SINS)."
- Studies defining or assessing spinal neoplastic instability and those using SINS for prognosis were included.
Main Results:
- Out of 1414 identified articles, 51 met the inclusion criteria.
- No standardized definition or validated tool for spinal neoplastic instability existed before SINS.
- Since 2010, SINS has been widely adopted in the literature for assessing spinal instability.
- Twelve studies explored SINS's prognostic value, particularly in patients undergoing radiotherapy or surgery.
Conclusions:
- The introduction of SINS has led to more uniform reporting of spinal neoplastic instability.
- A clear consensus on the definition, assessment, and reporting of spinal neoplastic instability was absent before SINS.
- The prognostic utility of SINS is currently considered controversial.
