A score for rating instability in spinal metastases and the usefulness of conservative measures for instability

: Spinal instability in patients with spinal metastatic disease plays a role in the selection of surgical intervention. The classic 'three-column model' used in traumatology to assess the stability of the spinal column is not always applicable to spinal metastatic disease. The recently introduced Spinal Instability Neoplastic Score (SINS) is the first instrument that can be used to classify instability in spinal metastatic disease. Utilisation of the SINS by the medical community could lead to more uniformity, which could prevent a delay in the treatment of patients with spinal instability. Only a select group of patients with spinal instability due to metastatic disease is eligible for spinal surgery. Other patients are often prescribed bed rest or other conservative treatment. The usefulness of such treatments, however, has not been adequately substantiated.