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Is the Spinal Instability Neoplastic Score Accurate and Reliable in Predicting Vertebral Compression Fractures for Spinal Metastasis? A Systematic Review and Qualitative Analysis

Authors
 Lee, Chang-Hyun  ;  Hong, Jae Taek  ;  Lee, Sun-Ho  ;  Yi, Seong  ;  Sohn, Moon-Jun  ;  Kim, Sung Hwan  ;  Chung, Chun Kee 
Citation
 JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, Vol.64(1) : 4-12, 2021-01 
Journal Title
 JOURNAL OF KOREAN NEUROSURGICAL SOCIETY 
ISSN
 2005-3711 
Issue Date
2021-01
Keywords
Spine ; Metastasis ; Spinal neoplastic instability score ; Fractures, Compression ; Radiotherapy
Abstract
Spinal metastases can present with varying degrees of mechanical instability. The Spinal Instability Neoplastic Score (SINS) was developed as a tool to assess spinal neoplastic-related instability while helping to guide referrals among oncology specialists. Some previous papers suggested that the SINS was accurate and reliable, while others disagreed with this opinion. We performed a systematic review regarding the SINS to evaluate its accuracy and precision in predicting vertebral compression fractures (VCFs). The 21 included studies investigated a total of 2118 patients. Thirteen studies dealt with the accuracy of SINS to predict post-radiotherapy VCFs, and eight dealt with the precision. Among 13 studies, 11 agreed that the SINS categories showed statistically significant accuracy in predicting VCF. Among eight studies, body collapse was effective for predicting VCFs in six studies, and alignment and bone lesion in two studies. Location has no statistical significance in predicting VCFs in any of the eight studies. The precision of SINS categories was substantial to excellent in six of eight studies. Among the six components of the SINS, the majority of the included studies reported that location showed near perfect agreement; body collapse, alignment, and posterolateral involvement showed moderate agreement; and bone lesion showed fair agreement. Bone lesion showed significant accuracy in predicting VCFs in half of eight studies, but displayed fair reliability in five of seven studies. Although location was indicated as having near perfect reliability, the component showed no accuracy for predicting VCFs in any of the studies and deleting or modifying the item needs to be considered. The SINS system may be accurate and reliable in predicting the occurrence of post-radiotherapy VCFs for spinal metastasis. Some components seem to be substantially weak and need to be revised.
DOI
10.3340/jkns.2020.0105
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Yi, Seong(이성)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181878
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