Revised Tokuhashi Score — Prognosis in Spinal Metastasis

The Revised Tokuhashi Score predicts estimated survival in patients with spinal metastasis to guide the extent of surgical intervention. A total score of 0–15 across 6 parameters (general condition KPS, number of extraspinal bone metastases, number of vertebral body metastases, internal organ metastases, primary tumor site, and spinal cord palsy) determines whether surgery should be palliative, limited, or excisional. Developed and revised by Tokuhashi et al. in 2005 from a Japanese cohort of 246 patients.