Metastatic spinal cord compression: the Spinal Instability Neoplastic Score and early surgical intervention

BMJ Support Palliat Care. 2024 Mar 8:spcare-2023-004537. doi: 10.1136/spcare-2023-004537. Online ahead of print.

Abstract

Objectives: To evaluate the value of Spinal Instability Neoplastic Score (SINS) in patients with spine metastasis who subsequently developed or did not develop metastatic spinal cord compression (MSCC).

Methods: In this single institutional retrospective descriptive observational study, of 589 patients with MSCC who were referred for radiotherapy, 34 patients (with 41 compression sites) met the inclusion criteria: availability of diagnostic MRI spine pre-development of MSCC (MRI-1) and at the time of MSCC development (MRI-2) (CordGroup).For comparison, NoCordGroup consisted of 152 patients (160 sites) treated with radiotherapy to spinal metastases. SINS was compared between the two groups.

Results: In CordGroup, the median interval between MRI-1 and MRI-2 was 11 weeks. The median SINS was 8 (range: 4-14) and 9 (range: 7-14) on MRI-1 and MRI-2, respectively. In NoCordGroup, the median SINS was 6 (range: 4-10).

Conclusions: Our study showed a trend in difference in SINS value between the two groups. This difference should be a subject of future prospective research in this patient population with poor survival.

Keywords: Bone.