Introduction: Chronic low back pain (LBP)can be a debilitating syndrome with musculoskeletal and neuropathic pain features. Botulinum toxin type A (BoNT-A) is FDA approved for the treatment of cervical dystonia, blephoraspasm, hemifacial spasm and other conditions but is also used widely for treatment of migraine headaches, limb spasticity from stroke, multiple sclerosis and other causes, often with reduction of pain. Prior studies have shown that BoNT-A is efficacious for LBP. Animal studies suggest that BoNT-A may be efficacious for pain not only by the known neuromuscular blocking mechanism for relief of spasm but also by modulating substance-P, glutamate receptors, periperal nociceptors and other neuropathic pain messenger sustems. BoNT-A may have a unique benefit in patients with chronic LBP which often has both a musculoskeletal and neuropathic component. Cutaneous allodynia may accompany post-operative LBP, and BoNT-A has been shown to be effective with cutaneous allodynia such as in post-herpetic neuralgia. Methods: We have reviewed 80 patients who have received BoNT-A for LBP over the last 3 years with good results and have identified 10 patients who have been the most benefited in an attempt to predict which patients may be more likely to respond to BoNT-A treatments, especially after failing surgery, intervential blocks, physical therapy and medications. Results: These 10 patients have all been post-laminectomy patients who have had cutaneous allodynia as a complication of their post-laminectomy syndrome. There may be a special responsiveness to BoNT-A treatment for patients with neuropathic pain accompanied with cutaneous allodynia in the post-laminectomy patient.