Twelve studies specifically investigated the prognostic value of SINS in patients who underwent radiotherapy or surgery. Since the publication of SINS in 2010, the vast majority of the literature regarding spinal instability has used SINS to assess or describe instability. No precise definition or validated assessment tool was used specific to spinal neoplastic-related instability prior to the introduction of SINS. The search identified 1414 articles, of which 51 met the inclusion criteria. Primary outcomes included studies describing and/or defining neoplastic-related instability, SINS, and studies using SINS as a prognostic factor. Studies describing spinal neoplastic-related instability were eligible for inclusion. PubMed, Embase, and clinical trial databases were searched with the key words "spinal neoplasm," "spinal instability," "spinal instability neoplastic score," and synonyms. Spinal neoplastic-related instability was defined in 2010 and simultaneously SINS was introduced as a novel tool with criteria agreed upon by expert consensus to assess the degree of spinal stability. How has SINS affected daily clinical practice? 3. How is spinal neoplastic instability defined or classified in the literature before and after the introduction of the Spinal Instability Neoplastic Score (SINS)? 2. To address the following questions in a systematic literature review: 1.
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December 2022
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