Spinal Instability Neoplastic Score (SINS)

SINS

Sum the Fisher 2010 Spinal Instability Neoplastic Score from six caller-assigned items and return the published 0–18 integer total. Not later SOSG stability strata and not an operative order.

LIVE $0.005 USDC GET /api/calc/sins

Markdown: /docs/sins.md · Canonical: https://magentlab.com/docs/sins

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Sum the Fisher 2010 Spinal Instability Neoplastic Score from six caller-assigned items and return the published 0–18 integer total. Not later SOSG stability strata and not an operative order.

When to use

When an agent has already assigned Fisher 2010 SINS items for neoplastic spinal disease and needs the published integer sum, not TLICS (trauma), not an operative order, and not later SOSG 0–6 / 7–12 / 13–18 stability strata.

When not to use

Not a medical device. magent does not read imaging. Location, pain, bone lesion quality, alignment, vertebral body collapse, and posterolateral involvement are caller-assigned.
Not an operative order. The returned value is the Fisher 2010 integer sum only.
Not TLICS. This tool is the Spine Oncology Study Group neoplastic score, not Vaccaro 2005 trauma classification.
Fisher 2010 Table 8 sum only (max 18). magent does not apply later SOSG stability strata (0–6 / 7–12 / 13–18).

Formula

SINS = location (junctional 3, mobile 2, semirigid 1, rigid 0) + pain (mechanical 3, occasional_not_mechanical 1, pain_free 0) + bone (lytic 2, mixed 1, blastic 0) + alignment (subluxation_translation 4, de_novo_deformity 2, normal 0) + collapse (gt_50 3, le_50 2, no_collapse_gt_50pct_body 1, none 0) + posterolateral (bilateral 3, unilateral 1, none 0); Fisher 2010 Table 8; max 18

Citation

Title: A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group.
Authors: Fisher CG, DiPaola CP, Ryken TC, et al.
Source: Spine (Phila Pa 1976). 2010;35(22):E1221-E1229
DOI: 10.1097/BRS.0b013e3181e16ae2

Worked example

All minimum grades

Given: alignment=normalbone=blasticcollapse=nonelocation=rigidpain=pain_freeposterolateral=none

rigid 0 + pain_free 0 + blastic 0 + normal 0 + none 0 + none 0
Score = 0 (max 18). Fisher 2010 integer sum only; no later SOSG stability strata

All maximum grades

Given: alignment=subluxation_translationbone=lyticcollapse=gt_50location=junctionalpain=mechanicalposterolateral=bilateral

junctional 3 + mechanical 3 + lytic 2 + subluxation_translation 4 + gt_50 3 + bilateral 3
Score = 18 (max 18). Not an operative order

Also searched as

SINS
Spinal Instability Neoplastic Score
Spinal Instability Neoplastic Scale
Fisher SINS
SOSG SINS
neoplastic spinal instability
Fisher 2010 SINS
spine oncology SINS

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/sins?location=rigid&pain=pain_free&bone=blastic&alignment=normal&collapse=none&posterolateral=none

Full URL: https://api.magentlab.com/api/calc/sins?location=rigid&pain=pain_free&bone=blastic&alignment=normal&collapse=none&posterolateral=none

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/sins?location=rigid&pain=pain_free&bone=blastic&alignment=normal&collapse=none&posterolateral=none"

Parameters

Name	Type	Required	Description
`location`	string	required · junctional, mobile, semirigid, rigid	Caller-assigned SINS location (Fisher 2010 Table 8). junctional (occiput-C2, C7–T2, T11–L1, L5–S1) scores 3; mobile (C3–C6, L2–L4) scores 2; semirigid (T3–T10) scores 1; rigid (S2–S5) scores 0. magent does not read imaging.
`pain`	string	required · mechanical, occasional_not_mechanical, pain_free	Caller-assigned pain (Fisher 2010): pain relief with recumbency and/or pain with movement/loading. mechanical (yes) scores 3; occasional_not_mechanical (occasional pain but not mechanical) scores 1; pain_free scores 0. magent does not interview the patient.
`bone`	string	required · lytic, mixed, blastic	Caller-assigned bone lesion quality (Fisher 2010). lytic scores 2; mixed scores 1; blastic scores 0. magent does not read imaging.
`alignment`	string	required · subluxation_translation, de_novo_deformity, normal	Caller-assigned radiographic spinal alignment (Fisher 2010). subluxation_translation scores 4; de_novo_deformity (kyphosis/scoliosis) scores 2; normal scores 0. magent does not read imaging.
`collapse`	string	required · gt_50, le_50, no_collapse_gt_50pct_body, none	Caller-assigned vertebral body collapse (Fisher 2010). gt_50 (>50% collapse) scores 3; le_50 (≤50% collapse) scores 2; no_collapse_gt_50pct_body (no collapse with >50% body involved) scores 1; none scores 0. magent does not read imaging.
`posterolateral`	string	required · bilateral, unilateral, none	Caller-assigned posterolateral involvement of spinal elements (facet, pedicle, or costovertebral joint fracture or replacement with tumor; Fisher 2010). bilateral scores 3; unilateral scores 1; none scores 0. magent does not read imaging.

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/sins Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

1 to 25 items. Each item uses the same keys as the GET query parameters.
POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "alignment": "normal",
      "bone": "blastic",
      "collapse": "none",
      "location": "rigid",
      "pain": "pain_free",
      "posterolateral": "none"
    },
    {
      "alignment": "normal",
      "bone": "blastic",
      "collapse": "none",
      "location": "rigid",
      "pain": "pain_free",
      "posterolateral": "none"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/sins",
  "items": [
    {
      "location": "rigid",
      "components": [
        {
          "value": "rigid",
          "factor": "location",
          "points": 0,
          "present": true
        },
        {
          "value": "pain_free",
          "factor": "pain",
          "points": 0,
          "present": true
        },
        {
          "value": "blastic",
          "factor": "bone",
          "points": 0,
          "present": true
        },
        {
          "value": "normal",
          "factor": "alignment",
          "points": 0,
          "present": true
        },
        {
          "value": "none",
          "factor": "collapse",
          "points": 0,
          "present": true
        },
        {
          "value": "none",
          "factor": "posterolateral",
          "points": 0,
          "present": true
        }
      ],
      "collapse": "none",
      "alignment": "normal",
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Fisher CG, DiPaola CP, Ryken TC, et al.",
        "doi": "10.1097/BRS.0b013e3181e16ae2",
        "id": "fisher-2010",
        "pmid": "20562730",
        "source": "Spine (Phila Pa 1976). 2010;35(22):E1221-E1229",
        "title": "A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group."
      },
      "formula": "sins",
      "formula_expression": "SINS = location (junctional 3, mobile 2, semirigid 1, rigid 0) + pain (mechanical 3, occasional_not_mechanical 1, pain_free 0) + bone (lytic 2, mixed 1, blastic 0) + alignment (subluxation_translation 4, de_novo_deformity 2, normal 0) + collapse (gt_50 3, le_50 2, no_collapse_gt_50pct_body 1, none 0) + posterolateral (bilateral 3, unilateral 1, none 0); Fisher 2010 Table 8; max 18",
      "max_score": 18,
      "score": 0,
      "pain": "pain_free",
      "bone": "blastic",
      "posterolateral": "none"
    },
    {
      "location": "rigid",
      "components": [
        {
          "value": "rigid",
          "factor": "location",
          "points": 0,
          "present": true
        },
        {
          "value": "pain_free",
          "factor": "pain",
          "points": 0,
          "present": true
        },
        {
          "value": "blastic",
          "factor": "bone",
          "points": 0,
          "present": true
        },
        {
          "value": "normal",
          "factor": "alignment",
          "points": 0,
          "present": true
        },
        {
          "value": "none",
          "factor": "collapse",
          "points": 0,
          "present": true
        },
        {
          "value": "none",
          "factor": "posterolateral",
          "points": 0,
          "present": true
        }
      ],
      "collapse": "none",
      "alignment": "normal",
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Fisher CG, DiPaola CP, Ryken TC, et al.",
        "doi": "10.1097/BRS.0b013e3181e16ae2",
        "id": "fisher-2010",
        "pmid": "20562730",
        "source": "Spine (Phila Pa 1976). 2010;35(22):E1221-E1229",
        "title": "A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group."
      },
      "formula": "sins",
      "formula_expression": "SINS = location (junctional 3, mobile 2, semirigid 1, rigid 0) + pain (mechanical 3, occasional_not_mechanical 1, pain_free 0) + bone (lytic 2, mixed 1, blastic 0) + alignment (subluxation_translation 4, de_novo_deformity 2, normal 0) + collapse (gt_50 3, le_50 2, no_collapse_gt_50pct_body 1, none 0) + posterolateral (bilateral 3, unilateral 1, none 0); Fisher 2010 Table 8; max 18",
      "max_score": 18,
      "score": 0,
      "pain": "pain_free",
      "bone": "blastic",
      "posterolateral": "none"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	sins
`formula_expression`	string	Exact expression used
`score`	integer	Fisher 2010 SINS integer sum 0-18. Not later SOSG stability strata.
`max_score`	integer	18
`location`	string	Caller-assigned location used (junctional, mobile, semirigid, or rigid)
`pain`	string	Caller-assigned pain used (mechanical, occasional_not_mechanical, or pain_free)
`bone`	string	Caller-assigned bone lesion quality used (lytic, mixed, or blastic)
`alignment`	string	Caller-assigned alignment used (subluxation_translation, de_novo_deformity, or normal)
`collapse`	string	Caller-assigned vertebral body collapse used (gt_50, le_50, no_collapse_gt_50pct_body, or none)
`posterolateral`	string	Caller-assigned posterolateral involvement used (bilateral, unilateral, or none)
`components`	array	Per-factor Fisher 2010 Table 8 points
`citation`	object	Fisher et al. Spine 2010 citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "location": "rigid",
  "components": [
    {
      "value": "rigid",
      "factor": "location",
      "points": 0,
      "present": true
    },
    {
      "value": "pain_free",
      "factor": "pain",
      "points": 0,
      "present": true
    },
    {
      "value": "blastic",
      "factor": "bone",
      "points": 0,
      "present": true
    },
    {
      "value": "normal",
      "factor": "alignment",
      "points": 0,
      "present": true
    },
    {
      "value": "none",
      "factor": "collapse",
      "points": 0,
      "present": true
    },
    {
      "value": "none",
      "factor": "posterolateral",
      "points": 0,
      "present": true
    }
  ],
  "collapse": "none",
  "alignment": "normal",
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Fisher CG, DiPaola CP, Ryken TC, et al.",
    "doi": "10.1097/BRS.0b013e3181e16ae2",
    "id": "fisher-2010",
    "pmid": "20562730",
    "source": "Spine (Phila Pa 1976). 2010;35(22):E1221-E1229",
    "title": "A novel classification system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group."
  },
  "formula": "sins",
  "formula_expression": "SINS = location (junctional 3, mobile 2, semirigid 1, rigid 0) + pain (mechanical 3, occasional_not_mechanical 1, pain_free 0) + bone (lytic 2, mixed 1, blastic 0) + alignment (subluxation_translation 4, de_novo_deformity 2, normal 0) + collapse (gt_50 3, le_50 2, no_collapse_gt_50pct_body 1, none 0) + posterolateral (bilateral 3, unilateral 1, none 0); Fisher 2010 Table 8; max 18",
  "max_score": 18,
  "score": 0,
  "pain": "pain_free",
  "bone": "blastic",
  "posterolateral": "none"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_sins`	SINS items must use Fisher 2010 values (location junctional/mobile/semirigid/rigid; pain mechanical/occasional_not_mechanical/pain_free; bone lytic/mixed/blastic; alignment subluxation_translation/de_novo_deformity/normal; collapse gt_50/le_50/no_collapse_gt_50pct_body/none; posterolateral bilateral/unilateral/none). Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

TLICS — Sum the Vaccaro 2005 Thoracolumbar Injury Classification and Severity (TLICS) score from caller-assigned injury morphology, posterior ligamentous complex integrity, and neurologic status, and return the published 0–10 total and treatment-guidance band.

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
Execution is timeout-bounded and concurrency-capped.
Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.