Metastatic Epidural Spinal Cord Compression: An Update of Best Practice

The Spine Instability Neoplastic Score SINS is a very important tool; it helps clinicians in identifying when patients with neoplastic disease of the spine should benefit from surgical consultation [2]. The treatment strategy algorithm of Paton et al. [3](LMNOP), evaluates the number of spinal Levels involved and the Location of disease in the spine (L), Mechanical instability (M), Neurology (N), Oncology (O), Patient fitness, Prognosis and response to Prior therapy (P). It helps taking the best decision in each particular patient. Finally, the Oswestry Spinal Risk Index (OSRI) score, developed by Balain et al. [4], is a simple score that can predict life expectancy accurately in patients presenting with spinal metastases. It is helpful in making difficult clinical decisions without the delay of extensive investigations.