ArticleJournal of pain research2026
Retrograde Intrathecal Catheter Placement at L5/S1 for Sacropelvic Cancer Pain: A Pilot Feasibility Study.
Article in Journal of pain research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Background: Intrathecal drug delivery systems have a role in treating cancer pain. For patients with predominant sacropelvic pain, caudally directed retrograde catheter placement targeting L5/S1 represents an alternative strategy that has been less well described. Objective: This pilot study evaluated outcomes associated with retrograde intrathecal catheter placement in patients with refractory sacropelvic cancer pain, with a primary focus on systemic opioid reduction and discharge facilitation. Methods: This pilot retrospective, pre-post cohort study was conducted at two academic medical centers between January 2021 and September 2024. Seven patients with cancer-related sacropelvic pain who received a caudally directed (retrograde) intrathecal catheter with tip positioning at L5/S1 were included. Pre-intervention data, including pain scores and daily oral plus intravenous opioid requirement, were collected and compared (two-tailed paired Results: Systemic (oral plus intravenous) opioid use decreased substantially from a pre-intervention mean of 731.8 ± 515.8 mg oral morphine equivalents (OME) in the 24 hours prior to intrathecal delivery system placement to 195.9 ± 93.4 mg in the 24 hours prior to discharge (t = 3.112, Conclusion: In this small retrospective pilot cohort, retrograde L5/S1 intrathecal catheter placement was associated with substantial systemic opioid reduction and discharge facilitation. Findings are exploratory and hypothesis-generating; prospective comparative studies are needed.
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