{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:20:01Z","timestamp":1787242801767,"version":"build-2736575974"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Introduction: Epidural steroid injections (ESIs) are a common interventional treatment for managing spinal pain complaints. Despite their widespread use, practice patterns among physicians performing ESIs vary significantly. This study aimed to evaluate preprocedural imaging review by pain physicians who perform ESIs in the cervical, thoracic, and lumbar spine. Methods: A survey was distributed to a cohort of physicians who regularly perform ESIs. The survey comprised questions regarding preprocedural imaging review before performing ESIs in the cervical, thoracic, and lumbar spine. The respondents included a diverse group of pain management physicians from various specialties and practice settings. Results: The results revealed that the majority of interventional pain management physicians personally interpret their own imaging, followed by a significant percentage of physicians who rely on the radiology reports. There were no physicians who did not perform any imaging review prior to ESIs. Whereas all respondents reported some form of imaging review, only 63.86%, 53.75%, and 64.44% reviewed the actual images prior to cervical, thoracic, and lumbar access, respectively. Conclusions: This survey provides initial data regarding imaging reviews among physicians who perform ESIs. Our results demonstrate that physicians treat imaging review as an essential component of the preprocedural process for performing ESIs, as all physicians reported that they perform some form of imaging review before performing ESIs. However, there is only partial adherence to the multidisciplinary working group opinion that segmental imaging should be reviewed for adequacy of space prior to cervical epidural access.<\/jats:p>","DOI":"10.3390\/diagnostics15060729","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T07:02:16Z","timestamp":1741935736000},"page":"729","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Preprocedural Imaging Review Before Performing Epidural Steroid Injections: Analysis of Physician Practice Parameters"],"prefix":"10.3390","volume":"15","author":[{"given":"Jamal","family":"Hasoon","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1043-7084","authenticated-orcid":false,"given":"Aila","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6276-9056","authenticated-orcid":false,"given":"Christopher L.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Harvard Medical School, Brigham and Women\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2819-4751","authenticated-orcid":false,"given":"Grant H.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0812-5356","authenticated-orcid":false,"given":"Jatinder","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"key":"ref_1","first-page":"S27","article-title":"Epidural Interventions in the Management of Chronic Spinal Pain: American Society of Interventional Pain Physicians (ASIPP) Comprehensive Evidence-Based Guidelines","volume":"24","author":"Manchikanti","year":"2021","journal-title":"Pain Physician"},{"key":"ref_2","first-page":"E889","article-title":"Comparative Systematic Review and Meta-Analysis of Cochrane Review of Epidural Injections for Lumbar Radiculopathy or Sciatica","volume":"25","author":"Manchikanti","year":"2022","journal-title":"Pain Physician"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1097\/ALN.0b013e31820fc7f2","article-title":"Injury and liability associated with cervical procedures for chronic pain","volume":"114","author":"Rathmell","year":"2011","journal-title":"Anesthesiology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/papr.12709","article-title":"Safe Use of Epidural Corticosteroid Injections: Recommendations of the WIP Benelux Work Group","volume":"19","author":"Rijsdijk","year":"2019","journal-title":"Pain Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1097\/ALN.0000000000000614","article-title":"Safeguards to Prevent Neurologic Complications after Epidural Steroid Injections. 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