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Mirel Score and Spinal Instability Neoplastic (SIN) Score calculator. Quickly calculate the risk of fracture for patients with metastasis to bone and the risk of instability for patients with spinal metastasis. Featuring real-time updated calculations, associated clinical reference material and recommended clinical management such as whether a consult to an orthopedic surgeon is indicated. Thanks for using Bone Mets Calculator and please check out our other applications for more useful cancer assessment tools.