摘要： Failed low back surgery syndrome (FLBSS) is a term describing chronic, disabling low back pain, with or without radicular pain following one or more spine surgeries. It can result in disastrous emotional and financial consequences to the patient. FLBSS has considerable impact on the patient and health care system. The clinical feature of FLBSS is chronic postoperative pain. Pain may locate in axial (low back) or radicular (down to the leg) distributions and may be presented as mechanical pain, which is aggravated by weight-bearing activities; or neuropathic pain, which is a more constant, unbearable pain locating in a radicular distribution. Patients with significant levels of depression, anxiety, somatization, and hypochondriasis are at high-risk of developing FLBSS. Poor outcome after back surgery may also be due to the residual neurologic compression, spinal instability, neuropathic injury and fusion disease. Surgical complications such as infection, nerve injury, hematoma, and pseudomeningocele can also result in FLBSS. Diagnostic evaluation of FLBSS includes plain radiographs, CT scans, MRI, nerve root injection and diagnostic blocks. Plain radiographs include anterior-posterior, lateral, oblique and flexion/extension view in standing position. Loss of normal lordosis, hardware placement, prior laminectomy defects, plstlaminectomy fractures of the pars, as well as spondylolisthesis should be noted. CT scan provides very useful information in investigating the hardware placement, central and lateral recess stenosis, and bone fusion quality. MRI will provide precise visualization of disk disease and spinal stenosis, and adjacent segments. Gadolinium-enhanced MRI can help distinguish recurrent or residual disk herniations (without enhancing) from scar tissue formation (enhancing). Nerve root injections or blocks are helpful both as diagnostic and therapeutic method. Management of patients diagnosed with FLBSS should be in an interdisciplinary environment and each patient deserves individual consideration for treatment. For restoration of functional ability, improvement of life quality, and pain self-management, psychological therapy should be emphasized in addition to surgical and medical therapies. The objectives of revision surgery in patients with FLBSS include decompression of all compressed neural elements, restoration of physiologic lordosis and balance, stabilization of unstable segments with internal fixation, and implant graft material to facilitate fusion. In the acute stages after operation, rehabilitation is critical to increase patient independent ability and to decrease muscle spasm and restore flexibility. In the chronic stages, an intensive rehabilitation program comprising physical therapy, pain management, psychological support, exercise therapy, and occupational therapy is recommended. Medications is also an effective modality for the treatment of patients with FLBSS. Narcotic analgesics, antidepressant, antiinflammatories and muscle relaxants may be prescribed as needed. Medial branch radiofrequency rhizotomy applies to patients with low back pain originating from the zygoapophysial joint. Spinal cord stimulation is usually considered for patients with neuropathic/radicular pain who had failed all other therapies. Intrathecal analgesic delivery implant systems may be helpful to patients who had undergone all medically appropriate treatments, but patients may experience inadequate analgesia or intolerable side effects.