• Ali Fatih Ramazanoğlu, Serdar Onur Aydın, Mustafa Umut Etli, Caner Sarıkaya, Eyüp Varol, and Sait Naderi.
• Department of Neurosurgery, Health Sciences University, Ümraniye Training and Research Hospital, Istanbul, Turkey.
• World Neurosurg. 2022 May 1; 161: e303-e307.

ObjectiveThe decision to perform surgery in cases of spinal plasmacytoma (SP) is controversial. This study aimed to evaluate the reliability of the Spinal Instability Neoplastic Score (SINS) in evaluation of spinal instability in patients with SP.MethodsClinical and radiological characteristics of 10 patients with SP were retrospectively evaluated. Age, sex, preoperative symptoms, duration of symptoms, pain score, American Spinal Injury Association score, and SINS were analyzed.ResultsThe 10 patients included 6 men and 4 women. Plasmacytoma was located in the sacrum in 1 patient, in the lumbar spine in 2 patients, in the thoracic spine in 6 patients, and in the cervical spine in 1 patient. Biopsy was performed in 2 patients, biopsy and vertebroplasty were performed in 2 patients, and biopsy and acute decompression and stabilization surgery were performed in 6 patients. SINS was <7 in 1 patient, 7-12 in 5 patients, and >12 in 4 patients. Two patients with a low SINS (<13) underwent only biopsy, and 2 patients underwent biopsy and vertebroplasty. Decompression and stabilization surgery was performed in 2 patients with SINS 7-12 and 4 patients with SINS >12.ConclusionsDecision making regarding augmentation, decompression, and stabilization in patients with SP is controversial. SINS may play a role during the decision-making process. Augmentation can be performed in patients with painful SPs with osteolytic changes with or without fracture (SINS <13). Decompression and stabilization surgery is the first-choice treatment in patients with SINS >12.Copyright © 2022 Elsevier Inc. All rights reserved.

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