{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:18:48Z","timestamp":1790713128088,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Spinal malignancy\u2010related pain results from tumor, fracture, instability, inflammation, and\/or nerve root\/spinal cord compression. Systemic corticosteroids are commonly used but have many undesirable adverse effects that impact quality of life and continuation of cancer treatments. Epidural steroid injections (ESIs) may be a viable alternative pain treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study starts with a pragmatic review on the efficacy of ESIs to treat spinal malignancy\u2010related pain. Given the limited evidence, we supplement the study with a single\u2010center, retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A pragmatic review using PRISMA guidelines was conducted in MEDLINE, EMBASE, SCOPUS, and Cochrane Review. Then, a retrospective chart review was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A pragmatic review yielded 10 patients who underwent ESI for spinal malignancy\u2010related pain. Three patients had \u201cexcellent\u201d relief (\u2265\u00a050% relief), who all received thoracic injections. This amounted to level IV evidence and an inconclusive recommendation (Grade C) as per Wright\u2019s criteria. In our retrospective review, all thoracic cases achieved at least \u201cmoderate\u201d pain improvement (30% to 49% relief). 55.6% had \u201cexcellent\u201d relief. Lumbosacral injections resulted in 86.0% with at least \u201cmoderate\u201d relief and 69.8% with \u201cexcellent\u201d relief. Caudal injections were less likely to benefit than lumbosacral injections (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). The transforaminal approach resulted in the best relief. There were no adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is inconclusive evidence to use ESIs to treat spinal malignancy\u2010related pain in the current literature. Our retrospective review provides level III evidence for our conclusion that ESIs are safe and efficacious to treat spinal malignancy\u2010related pain. Thoracic\/lumbosacral injections led to significantly better pain relief compared with caudal injections.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12957","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T03:53:38Z","timestamp":1602042818000},"page":"285-298","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Epidural Steroid Injections for the Management of Spinal Malignancy\u2010Related Pain: A Pragmatic Review and Retrospective Study"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5192-8533","authenticated-orcid":false,"given":"Daniel Chun\u2010suk","family":"Oh","sequence":"first","affiliation":[{"name":"Department of Rehabilitation and Regenerative Medicine NewYork\u2010Presbyterian Hospital \u2010 University Hospital of Columbia and Cornell New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leia","family":"Rispoli","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Weill Cornell Medicine New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1876-9868","authenticated-orcid":false,"given":"Priyanka","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Weill Cornell Medicine New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1654-8639","authenticated-orcid":false,"given":"Amitabh","family":"Gulati","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Memorial Sloan Kettering Cancer Center New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30612-5"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/598148"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2007.0145"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2012-0293"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx567"},{"key":"e_1_2_10_7_1","first-page":"111","volume-title":"Neurologic complications of cancer","author":"Posner JB","year":"1995"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0885-3924(94)90200-3"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0959-8049(95)00320-I"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(95)00572-G"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1191\/026921601673324846"},{"key":"e_1_2_10_12_1","article-title":"Interventions for treatment of metastatic extradural spinal cord compression in adults (review)","volume":"9","author":"George R","year":"2015","journal-title":"Cochrane Database for Systematic Reviews."},{"key":"e_1_2_10_13_1","first-page":"18","article-title":"Levels of evidence and grades of recommendation","volume":"5","author":"Wright JG","year":"2005","journal-title":"AAOS Bull."},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-011-1243-y"},{"key":"e_1_2_10_15_1","first-page":"959","article-title":"Interventional pain management for sacroiliac tumors in the oncologic population: a case series and paradigm approach","volume":"18","author":"Hutson N","year":"2017","journal-title":"Pain Med."},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12813"},{"key":"e_1_2_10_17_1","first-page":"21","article-title":"Intradural and extradural corticosteroids for sciatic pain","volume":"3","author":"Hartman JT","year":"1974","journal-title":"Orthop Rev."},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2018.06.720"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2016.11.008"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2011.00615.x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"crossref","unstructured":"MathurR.Lumbar radiculopathy secondary to schwannomatosis: a case report. 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