MDCalc

Revised Tokuhashi Scoring System

Predicts survival in patients with spinal tumors.

General condition (Karnofsky Performance Status)

Number of extraspinal bone metastases foci

Number of metastases in the vertebral body

Metastases to the major internal organs

Primary site of the cancer

Spinal cord palsy (Frankel Grade)

Frankel Grade:
  • Grade A: Complete motor and sensory involvement.
  • Grade B: Complete motor involvement, some sensory sparing including sacral sparing.
  • Grade C: Functionally useless motor sparing.
  • Grade D: Functional motor sparing.
  • Grade E: No neurologic involvement.
  • Result:

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    Advice
    • Interpret the score in the context of a full clinical assessment and multidisciplinary expertise.
    • Align treatment intensity with predicted survival:
      • Individuals with a longer predicted survival may benefit from more aggressive surgical procedures and disease-modifying therapy.
      • Those with a poorer prognosis may fare better with minimally invasive or non-operative, symptom-focused care.