Spine Scores

Question 1

Tokuhashi Score components

Answer 1

1. General Condition
2. Number of Extraspinal bone metastasis foci
3. Number of metastasis in the vertebral body
4. Mets to major internal organs
5. primary site of cancer
6. Palsy

Question 2

Tokuhashi (Karnofsky General Condition)

Answer 2

0 - poor
1 - moderate
2 - good

Question 3

Tokuhashi (No of extraspinal bone mets)

Answer 3

0 - >=3
1 - 1-2
2 - 1

Question 4

Tokuhashi (No of mets vertebral body)

Answer 4

0 - >=3
1 - 1-2
2 - 1

Question 5

Tokuhashi (mets to major internal organs)

Answer 5

0 - unremovable
1 - removable
2 - no mets

Question 6

Tokuhashi (Primary site of cancer)

Answer 6

0 - lung, osteosarcoma, stomach, bladder, esophagus, pancreas
1 - liver, galbladder, unidentified
2 - others
3 - kidney, uterus
4 - rectum
5 - thyroid, breast, prostate, carcinoid tumor

Question 7

Tokuhashi (Palsy)

Answer 7

0 - complete (Frankel A,B)
1 - incomplete (Frankel C, D)
2 - none (Frankel E)

Question 8

Tokuhashi (survival prognosis)

Answer 8

0-8 - 85% lives conservative or palliative surgery
9-11 - 73% lives >6months; 30% >1 year -> palliative surgery or excisional surgery
12-15 - 95% lives >1yr -> excisional surgery

Question 9

Spinal Instability Neoplastic Scoring (SINS) Components

Answer 9

1. Location
2. Pain
3. Bone Lesion
4. Radiographic Spinal Alignment
5. Vertebral Body Collapse
6. Posterolateral Involvement of spinal elements

Question 10

SINS Location

Answer 10

3 - Junctional (occiput-c2; c7-t2, t11-l1, l5-s1)
2 - mobile spine (c3-c6; l2-l4)
1 - semiregid (t3-t10)
0 - rigid (s2-s5

Question 11

SINS pain

Answer 11

3 - yes
1 - occasional
0 - no pain

Question 12

SINS bone lesion

Answer 12

2 - lytic
1- mixed
0 - blastic

Question 13

SINS radiographic alignment

Answer 13

4 - subluxation/translation
2 - de novo deformity (kyphosis/scoliosis)
0 - normal alignment

Question 14

SINS vetebral body collapse

Answer 14

3 - >50% collapse

2 -

Question 15

SINS posterolateral involvement

Answer 15

3 - bilateral
1 - unilateral
0 - none

Question 16

TLICS morphology

Answer 16

0 - no abnormality
1 - compression
2 - burst
3 - rotation/translation
4 - distraction

Question 17

TLICS Posterior Ligamentous Complex

Answer 17

0 - intact
2 - suspected/indeterminate
3 - injured

Question 18

TLICS nuerologic status

Answer 18

0 - intact
2 - root injury
2 - complete cord
3 - incomplete cord
3 - cauda equina

Question 19

TLICS score decision

Answer 19

==5 - operative

Question 20

SLICS (morphology)

Answer 20

0 - no abnormality
1 - compression
2 - burst
3 - distraction
4 - rotation/translation

Question 21

SLICS (discoligamentous complex

Answer 21

0 - intact
1 - indeterminate
2 - disrupted

Question 22

SLICS neurologic status

Answer 22

0 - intact
1 - root injury
2 - complete cord injury
3 - incomplete cord injury
\+1 - continuous cord compression

Question 23

SLICS interpretation

Answer 23

==5 - operative

Question 24

JOA (motor dysfunction score of UE)

Answer 24

0 - inability to move hands
1 - inability to eat with spoon but able to move hands
2 - inability to button shirt but able to eat with spoon
3 - able to button shirt with great difficulty
4 - able to button shirt with slight difficulty
5 - no dysfunction

Question 25

JOA (motor dysfunction of LE)

Answer 25

0 - complete loss of motor and sensory functions
1 - sensory preservation without the ability to move legs
2 - able to move legs but unable to walk
3 - able to walk on flat floor with a walking aid
4 - able to go up/down stairs with handrail
5 - moderate to significant lack of stability
6 - mild lack of stability; able to walk with smooth reciprocation unaided
7 - no dysfunction

Question 26

JOA (sensory dysfunction UE)

Answer 26

0 - complete loss of sensation
1 - severe sensory loss or pain
2 - mild sensory loss
3 - no sensory loss

Question 27

JOA (sphincter dysfunction score)

Answer 27

0 - inability to micturate voluntarily
1 - marked difficulty with micturation
2 - mild to moderate difficulty with micturation
3 - normal micturation