Revised Tokuhashi Score Calculator

Revised Tokuhashi score for prognosis in metastatic spinal disease.

For educational and clinical reference. Not a substitute for medical judgment. See the medical disclaimer.

General condition (Karnofsky)

Number of extraspinal bone metastases foci

Number of metastases in vertebral body

Metastases to major internal organs

Primary site of cancer

Spinal cord palsy (Frankel)

Score

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Interpretation

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References

Tokuhashi Y, Matsuzaki H, Oda H, Oshima M, Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine. 2005;30(19):2186-2191.

How to use

Score each of the 6 parameters.
The total (0–15) and survival prediction update instantly.
Use the score to guide treatment intensity in conjunction with the Tomita score.

Frequently asked questions

What is the revised Tokuhashi score?

A 6-parameter prognostic score (0–15) for patients with metastatic spinal disease, used to guide whether excisional, palliative, or conservative treatment is appropriate.

What is the difference from the original Tokuhashi?

The revised (2005) version refines the primary site category and improves accuracy. Most centers use the revised version.

How accurate is the Tokuhashi score?

External validation shows ~ 60–75% concordance between predicted and actual survival. Newer modern primary tumor therapies may shift survival upward.

Tokuhashi vs Tomita?

Tokuhashi focuses on survival prognostication; Tomita focuses on surgical strategy (en bloc vs intralesional). They complement each other.

Last updated June 28, 2026