sins_spine_score: Spinal Instability Neoplastic Score (SINS)

In cliot: Clinical Indices and Outcomes Tools

Spinal Instability Neoplastic Score (SINS)

Description

Calculates the SINS score to assess spinal stability in patients with spinal neoplastic disease. The scale helps guide referrals to spinal surgeons by categorizing lesions as stable, indeterminate, or unstable based on six radiographic and clinical factors.

Usage

sins_spine_score(location, pain_type, bone_lesion_type, spinal_alignment,
                 vertebral_collapse, posterior_involvement)

Arguments

location	String. Location of the lesion. "junctional": Occiput-C2, C7-T2, T11-L1, L5-S1 (3 pts). "mobile": C3-C6, L2-L4 (2 pts). "semirigid": T3-T10 (1 pt). "rigid": S2-S5 (0 pts).
pain_type	String. Assessment of pain. "mechanical": Pain with movement/upright, relieved by recumbency (3 pts). "occasional_non_mechanical": Pain not clearly mechanical (1 pt). "pain_free": No pain (0 pts).
bone_lesion_type	String. Radiographic appearance of the bone lesion. "lytic" (2 pts). "mixed": Lytic/Blastic (1 pt). "blastic" (0 pts).
spinal_alignment	String. Radiographic spinal alignment. "subluxation_translation": Present (4 pts). "de_novo_deformity": Kyphosis or scoliosis (2 pts). "normal" (0 pts).
vertebral_collapse	String. Degree of vertebral body collapse. "gt_50_percent": >50% collapse (3 pts). "lt_50_percent": <50% collapse (2 pts). "no_collapse_gt_50_involved": No collapse but >50% body involvement (1 pt). "none": None of the above (0 pts).
posterior_involvement	String. Involvement of posterolateral elements (pedicles, facets, spinous processes). "bilateral" (3 pts). "unilateral" (1 pt). "none" (0 pts).

Value

A list containing:

SINS_Score	The calculated total score (Range 0-18).
Stability_Classification	Classification (Stable 0-6, Indeterminate 7-12, Unstable 13-18).
Recommendation	Clinical guidance on surgical consultation.

References

Fisher CG, DiPaola CP, Ryken TC, et al. A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group. Spine. 2010;35(22):E1221-1229. doi:10.1097/BRS.0b013e3181e16ae2

Examples

# Example 1: Unstable
# Junctional (3), Mechanical Pain (3), Lytic (2),
#Subluxation (4), >50% Collapse (3), Bilateral Posterior (3)
# Score = 18
sins_spine_score("junctional", "mechanical", "lytic",
"subluxation_translation", "gt_50_percent", "bilateral")

# Example 2: Stable
# Rigid (0), Pain Free (0), Blastic (0), Normal (0), None (0), None (0)
# Score = 0
sins_spine_score("rigid", "pain_free", "blastic", "normal", "none", "none")

cliot documentation built on Dec. 1, 2025, 1:06 a.m.