Spinal Instability Neoplastic Scale (SINS) ScoreLoading...Spine locationRigid (S2-S5)0Semirigid (T3-T10)+1Mobile spine (C3-C6, L2-L4)+2Junctional (occiput-C2, C7-T2, T11-L1, L5-S1)+3Presence of mechanical painNo (painless lesion)0No (occasional pain but not mechanical)+1Yes+3Bone lesion qualityBlastic0Mixed (lytic/blastic)+1Lytic+2Radiographic spinal alignmentNormal alignment0De novo deformity (kyphosis/scoliosis)+2Subluxation/translation present+4Vertebral body collapseNone of the following0No collapse with > 50% body involved+1< 50% collapse+2> 50% collapse+3Posterolateral involvement of spinal elementsNone of the following0Unilateral+1Bilateral+3