Spinal Instability Neoplastic Score (SINS)
Spinal Instability Neoplastic Score (SINS, 0–18) from six components; banded stable (0–6) / indeterminate (7–12) / unstable (13–18).
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Spinal location
- Junctional — occiput–C2, C7–T2, T11–L1, L5–S1 (3)
- Pain
- Mechanical / with loading (3)
- Bone-lesion quality
- Lytic (2)
- Radiographic alignment
- Normal alignment (0)
- Vertebral-body collapse
- None of the above (0)
- Posterolateral involvement
- None (0)
Result: SINS 8/18 — indeterminate / potentially unstable (7–12) — surgical consultation recommended.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Bands
- 0–6 stable, 7–12 indeterminate (potentially unstable), 13–18 unstable. A 7–18 score warrants a surgical / spine-oncology consult.
What you enter
- Spinal location
- Pain
- Bone-lesion quality
- Radiographic alignment
- Vertebral-body collapse
- Posterolateral involvement
How this is calculated
- Components
- six components sum 0–18: location (0–3), mechanical pain (0–3), bone lesion (0–2), alignment (0–4), vertebral-body collapse (0–3), and posterolateral element involvement (0–3).
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-E1229. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.