Revised Tokuhashi Score (metastatic spine prognosis)
Revised Tokuhashi Score (0–15) for metastatic-spine prognosis; a lower total is the worse prognosis (0–8 under 6 months, 9–11 ≥ 6 months, 12–15 ≥ 1 year).
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- General condition
- Good — KPS 80–100 (2)
- Extraspinal bone-metastasis foci
- 1–2 (1)
- Vertebral-body metastases
- 1 (2)
- Major-organ metastases
- Removable (1)
- Primary-tumor site
- Other (2)
- Palsy
- Incomplete — Frankel C, D (1)
Result: Revised Tokuhashi 9/15 — expected survival at least 6 months (9–11) — palliative surgery may be appropriate.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Parameters
- six parameters sum 0–15: general condition (KPS 0–2), extraspinal bone metastases (0–2), vertebral-body metastases (0–2), major-organ metastases (0–2), primary site (0–5), palsy (Frankel 0–2).
- Bands
- a lower total is the worse prognosis: 0–8 expected survival < 6 months, 9–11 ≥ 6 months, 12–15 ≥ 1 year, guiding how aggressive surgery should be.
What you enter
- General condition (Karnofsky)
- Extraspinal bone-metastasis foci
- Vertebral-body metastases
- Major-organ metastases
- Primary-tumor site
- Palsy (Frankel grade)
How this is calculated
Tokuhashi Y, Matsuzaki H, Oda H, Oshima M, Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine. 2005;30(19):2186-2191. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.