Revised Tokuhashi score

A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis.

Tokuhashi Y, Matsuzaki H, Oda H, et al. Spine 2005 · PMID 16205345 · doi:10.1097/01.brs.0000180401.06919.a5

Question

Can a preoperative score predict survival in patients with spinal metastases to guide the choice of surgery?

Design

Semi-prospective clinical study applying a revised scoring system to patients who had died after surgical or conservative treatment.

Patients

Patients with metastatic spinal tumours treated surgically or conservatively.

Intervention

Revised Tokuhashi score (0-15) from general condition, extraspinal and spinal bone metastases, visceral metastases, primary site and palsy

Comparison

Actual survival

Primary outcome

Predicted versus actual survival

Key result

Scores of 0-8 predicted survival under 6 months, 9-11 at least 6 months and 12-15 at least 1 year, and predicted prognosis agreed well with actual survival.

Limitations

Single-institution data from an era before targeted therapies; accuracy has been reduced in later external validation for some primaries.

Impact on practice

Used alongside SINS and clinical judgement in UK spinal MDTs to match the scale of surgery to expected survival.