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Revised Tokuhashi Scoring System

The revised Tokuhashi score predicts survival in patients with spinal metastases to guide the choice between conservative treatment, palliative surgery, or excisional surgery.

Purpose:
Estimate survival and guide surgical decision-making for spinal metastases
Population:
Patients with metastatic spinal tumours being considered for surgery
Factors:
General condition (KPS), Number of extraspinal bone metastases, Number of vertebral metastases, Metastases to major internal organs, Primary tumour site, Spinal cord palsy
Reference:
Tokuhashi et al., Spine 2005
HomeTokuhashi Score Calculator — Spine Metastases Surgical Prognosis
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Tokuhashi Score Calculator — Spine Metastases Surgical Prognosis

Clinical Context & Background

The Revised Tokuhashi Score (2005) is a prognostic scoring system for patients with spinal metastases. It assesses general condition, extraspinal bone metastases, number of vertebral metastases, metastases to internal organs, primary site, and spinal cord palsy. The total score helps decide between excisional surgery, palliative surgery, or non-surgical management.
Primary Source EvidenceTokuhashi Y, Matsuzaki H, Oda H, Oshima M, Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976). 2005;30(15):1786-1792.
Formula Logic
Sum of 6 parameters (0-15 points).

Reference Data

Total ScorePredicted SurvivalTreatment Strategy
0 - 8< 6 monthsConservative / Palliative Surgery
9 - 11≥ 6 monthsPalliative Surgery / Radiotherapy
12 - 15≥ 1 yearExcisional Surgery likely appropriate

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