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Lower back pain (LBP) is one of the most common diseases in adults. The cumulative lifetime prevalence of LBP lasting at least two weeks is 13.8–30%. In addition, 70–85% of all people have back pain at some time in their life. Posterior axial neck pain is also common and the average annual incidence rate for cervical radiculopathy is 83.2 per 1. An epidural block is an interventional pain management procedure used to treat spinal pain. This procedure was introduced in 1952 by Robecchiet al. and its usefulness has been reported by many previous investigators. Definitive identification of the epidural space is essential for achieving a successful epidural block. The loss of resistance (LOR) technique, the most commonly used method to identify the epidural space, was introduced by Sicard and Forestier in 1921. This procedure is conducted by applying pressure to the plunger using one’s thumb. However, this method has some disadvantages. A clear loss of resistance may not be felt in patients with an abnormal ligamentumflavum. In addition, Zarzuret al. reported that there is no naturally occurring negative pressure that leads to a loss of resistance in the epidural space. These limitations may result in unintended puncture of the dura, spinal cord injury or epi/subdural hematoma. A dural puncture and leakage of cerebrospinal fluid (CSF) are the most common complications of an epidural block. It can cause a post-dural puncture headache, requiring that the patient be treated with bed rest, fluid therapy and hospitalization. In order to avoid these complications and enhance the safety and accuracy of this procedure, an epidural pressure checker (Epi-check, Silimed, Bucheon, Korea) was designed. The aim of this study was to identify the optimal negative pressure representing the epidural space in both the cervical and lumbar spine and to evaluate the accuracy of Epidural pressure checker ISSN 2466-0167 Asian J Pain 2016;2(1):6-9

Utility of an Epidural Pressure Checker in the Administration of Trans-Laminar Epidural Blocks