Sternal metastasis - the forgotten column and its effect on thoracic spine stability

Table 1 Spinal Instability Neoplastic Score

	Score
Spine location
Junctional (occiput-C2, C7-T2, T11-L1, L5-S1)	3
Mobile (C3-C6, L2-L4)	2
Semi-rigid (T3-T10)	1
Rigid (S2-S5)	0
Mechanical or postural pain
Yes	3
No (occasional pain but not mechanical)	1
Pain-free lesion	0
Bone lesion quality
Lytic	2
Mixed lytic/blastic	1
Blastic	1
Radiographic spinal alignment
Subluxation/translation	4
De novo deformity (kyphosis/scoliosis)	1
Normal	0
Vertebral body involvement
> 50% collapse	3
< 50% collapse	2
No collapse with > 50% involvement	1
None of the above	0
Posterior involvement
Bilateral	3
Unilateral	1
None	0