OBJECTIVES: The objectives of this study were to investigate the prevalence of neuropathic pain(NP) among patients scheduled for lumbar spinal surgery and the relationship between health-related quality of life(HRQoL) and NP. This study also aimed to identify the risk factors related to NP and compare the clinical outcomes and impact on the HRQoL after surgical treatment between patients with and without NP.   METHODS: This study was a nationwide, multicentered, cross-sectional, observational study. It was conducted from September 2011 to May 2013, and included a total of 1,109 patients who were scheduled for lumbar spinal surgery from 44 spinal centers (both orthopaedics and neurosurgeons). Patients were diagnosed of having NP if the Leeds Assessment of Neuropathic Symptoms and Signs(LANSS) pain scale criteria was ≥12 points. The patients were investigated to assess the differences in their clinical outcomes after 3 months of the surgery and were followed up with regards to pain and HRQoL to explore the risk factors affecting NP. RESULTS: Of 1,109 recruited patients, 404(36.4%) suffered from NP(mean age 62.1 years; 37.9% male) with mean LANSS score of 17.4±4.1, while 705(63.6%) had nociceptive pain with mean LANSS score of 6.0±3.5. Female and longer symptom duration were identified as risk factors for NP (OR 1.291 and 1.003, respectively, p<0.05). At baseline, patients with NP showed lower HRQoL and more severe pain compared to nociceptive pain patients. However, 3 months after surgical treatment, NP group showed greater improvement in pain(p=0.087) and HRQoL(p= 0.029) as compared to nociceptive pain group. CONCLUSIONS: There was a high prevalence of NP in Korean patients scheduled for lumbar spine surgery, and these patients suffered greater pain and lower HRQoL than nociceptive pain patients. The more remarkable improvement NP patients showed after treatment highlights the importance of appropriate diagnosis and treatment of NP.