It is estimated that 80% of people will experience low back pain during their lifetime. In recent decades, spine surgery has grown rapidly and the number of lumbar spine surgeries has steadily increased. Despite advances in technology, the failure rate of lumbar spine surgery has not changed substantially over the years, with the overall failure rate of lumbar spine surgery ranging from approximately 10% to 46%, and the number of patients diagnosed with failed lumbar spine surgery syndrome is expected to continue to increase. Failed lumbar spine surgery syndrome is characterized by prolonged low back and leg pain, and patients suffer Data suggest that the initial success rate of lumbar spine surgery exceeds 50%, but the success rate drops to 30% after the second surgery, 15% after the third surgery, and 5% after the fourth surgery, and that the success rate of lumbar spine surgery decreases with the number of surgeries performed Arts et al. found that ablation for the treatment of failed lumbar spine surgery syndrome After 15 months, the success rate in terms of perception, functional recovery, and pain relief was 35%.Parker et al. found that 2 years after discectomy, the rate of recurrence of back or leg pain ranged from 5% to 36%.Skolasky et al. statistically showed that 29.2% of patients experienced the same or increased pain 12 months after laminectomy. One study followed up lumbar disc herniation laminectomy patients 10 to 22 years after surgery and found that 74.6% of patients had residual low back pain and 12% required repeat surgery. Of course, failure rates vary between surgeries and surgical procedures, with lumbar discectomy, for example, indicating a higher success rate. This shows that the problem of recurrence of symptoms after lumbar spine surgery should not be ignored. 1.Conservative treatment Including drug treatment, Chinese medicine treatment, physical therapy, psychological treatment and so on. Drug treatment can achieve analgesic effect in a short time. Physiotherapy can help patients optimize their gait and posture, and improve muscle strength and body functions. Psychotherapy includes stress reduction and cognitive behavioral therapy. In addition, alternative therapies such as acupuncture should not be ignored. These measures should be combined with medication to maximize pain relief. (2) Interventional therapy Before interventional therapy, it is necessary to determine whether the patient’s pain is predominantly axial or radicular in nature, so that different strategies can be adopted. Axial pain is mainly lumbar pain, which is aggravated when the patient exerts force on the body and alleviated when he/she is lying down. Radicular pain is characterized by pain in the area of the nerve root pathway, radiating from the buttocks and thighs to the calves, often accompanied by sensory hypersensitivity, and is no longer limited to sciatica. For axial pain, the following treatment modalities are available: 1) dorsal medial branch of spinal nerve block and radiofrequency ablation 2) sacroiliac joint block: 3) intervertebral discography: intervertebral discogenic low back pain is a chronic lower back pain caused by intervertebral disc disorders (e.g., degeneration, fibrous ring tear, intervertebral disc inflammation, etc., which stimulate the pain receptors in the intervertebral discs), and it is a chemical substance-mediated pain. The following treatments are available for radicular pain: 1) Epidural injections Epidural steroid injections (ESIs) are the most commonly used procedure in pain clinics around the world, primarily for radiculopathy 2) Adhesion release Postoperative scarring is a natural part of tissue healing after any surgery, and spinal surgery may result in the formation of fibrotic adhesions in the epidural space. 3) Intrathecal slow-release analgesic implantation therapy This method is mostly used for cancer analgesia, but in recent years, it has also been applied to non-cancer chronic analgesia. 4) Spinal cord stimulation Spinal cord stimulation (SCS) is a method of pain relief by placing stimulating electrodes into the epidural space of the spinal canal, and stimulating the sensory neurons in the posterior horn of the spinal cord and the posterior columns of the spinal tract with a continuous electric current from the electrical impulse generator. Conduction bundle, to block the transmission of pain signals, so as to achieve the therapeutic purpose of the treatment method. In 1975, Dooley et al. invented the method of using puncture technology to place electrode wires into the epidural cavity and treat pain through low-current stimulation, which triggered the emergence of a boom in the use of spinal cord electrical stimulation for the treatment of pain in Europe and the United States. At that time, due to the limitations of equipment and theory, the therapeutic effect was not very stable. In recent years, with the deepening of understanding and the updating and improvement of equipment, the success rate and efficiency of treatment have been continuously improved. Currently, the SCS system consists of stimulating electrodes, extension wires, electrical pulse generators, and patient and physician programmed control devices. The stimulating electrodes are surgically placed into the epidural space and the extension leads are connected through a subcutaneous tunnel to an electrical pulse generator buried around the abdomen or buttocks. The electrical pulse generator generates a continuous low current to achieve the therapeutic effect. In Japan and the United States, it is now common to use wire or sheet electrodes with multi-electrode contacts that can reach the length of 3 vertebrae. This requires the spine surgeon to place and fix the electrodes in the epidural space of the intended spinal cord segment through a spinal plate opening surgery. Various studies in recent years on SCS for the treatment of postoperative pain after lumbar spine surgery and intractable neuralgia have shown that SCS is effective in about 80% of cases, and Kumar et al. reported that in 100 patients with failed backsurgery syndrome (FBSS), who had predominantly lower-extremity pain, 88% of the patients had significant pain improvement after SCS treatment. In neighboring Japan, there have also been many reports of SCS for the treatment of extremity neuralgia not arising from nerve root or spinal cord compression in recent years. The efficacy is also very obvious. SCS treatment can avoid drug dependence and other side effects caused by long-term use of analgesic drugs in pain patients. Q: What are the contraindications to SCS treatment? A: SCS is contraindicated in patients with the following diseases or symptoms: (1) myocardial infarction within 3 months; (2) severe hypertension or diabetes mellitus; (3) personality disorders or psychologically unstable patients; (4) pregnant patients; (5) implantable cardioverter-defibrillator (ICD) or pacemaker dependence; (6) patients with localized infections in the pre-implantation site; (7) patients with chronic pain in the implantation site; (8) patients with chronic pain in the implantation site; and (9) patients with chronic pain in the implantation site. (6) patients with localized infections at the preimplantation site; (7) patients in whom electrodes cannot be implanted because of severe spinal anatomic mechanism abnormalities; (8) patients on anticoagulant medications; and (9) patients with drug dependence. Q: What is the entire treatment process of spinal cord electrical stimulation? A: The treatment is generally divided into two phases, Phase I surgery (experiential treatment) and Phase II surgery (long-term treatment). 1. Evaluation and Setting Treatment Goals Before receiving treatment, you will need to communicate with your doctor about your goals and expectations. Phase I Surgery A very minimally invasive surgery in which the surgeon places electrodes into the epidural of the spinal cord, allowing you to experience and feel the effects of pain control during the surgery. 3.Experience treatment Back to the hospital room, you can continue to experience the spinal cord electrical stimulation treatment, you can self-adjust the stimulation intensity within the safety range set by the doctor, fully feel and adapt to determine the effect of the treatment. 4.Surgery Embedding the long-term neurostimulator system into the body. 5. Discharge Taking the patient controller home, you can control the symptoms by yourself. However, it is necessary to observe the precautions for self-care in daily life. 6. Regular Follow-up You will need to return to the hospital every six months or once a year for a follow-up visit. Preparation for Experience Therapy Q: What is experience therapy? A: One of the advantages of spinal cord stimulation is that before you decide to have a neurostimulator implanted for a long period of time, you can experience the effects of spinal cord stimulation and try it out to see if it can help you improve your symptoms. To undergo the experimental treatment, you will need to cooperate with your doctor to complete a very minor surgery. Although it needs to be done in an operating room, this is very different from back surgery. The doctor places a temporary electrode on your back in a similar way to a closed loop, and the other end of the electrode is connected to an external temporary system that can be hooked up to your waist and carried around. The temporary stimulator is turned on and it can perform almost the same function as an implanted stimulator. In this way, you can begin to experience the sensation of electrical stimulation of the spinal cord. On the operating table, the surgeon will ask to let you experience which setting feels best, and from there will decide where to leave the electrodes in place. After the procedure, you can return to your hospital room with the temporary system to continue the experience. The experience is a perceptual interaction that can be adjusted outside the body, and you can personally adjust your treatment settings within the safe parameters set by the doctor. When you feel uncomfortable, you can terminate it at any time without causing harm to your body. During the experiential treatment, you will be able to experience and judge for yourself the effect, the degree of improvement and whether you are satisfied. You can walk around and do most of the things you are used to doing. However, precautions should be observed to avoid conditions such as displacement of the device or infection. Experienced treatment usually lasts no more than 10 days and no longer than 14 days. Experiencing treatment for too long can lead to an increased risk of infection.