Introduction: Since an increased number of major spinal procedures, including revision surgery can 
be anticipated, we found it of relevance to assess a multimodal pain treatment strategy in patients 
undergoing surgery requiring instrumentation. Aim of the work: The aim of this randomized doubleblinded study to asses and compare the efficacy of using different doses of gabapentin and celecoxib 
as combination for analgesia in postoperative pain relieve in patient underwent posterior approach 
lumbar spine fixation surgery. Patients and Methods: After obtaining the local ethics committee of 
Minia University Hospital approval and written informed consent was taken from the patient, one 
hundred patients of both gender, Patients were randomized to four groups (25 patients in each group): 
Group GC received gabapentin 300mg + celecoxib 200mg 2hr preoperative and the same combination 
6 hr postoperative. Group G received gabapentin 300mg + celecoxib 200mg 2hr preoperative and 
gabapentin 300mg 6 hr postoperative. Group C received gabapentin 300mg + celecoxib 200mg at 
both 2hr preoperative and celecoxib 200mg 6 hr postoperative. Group O (placebo) as a control group 
received empty capsules 2hr preoperative and 6 hr postoperative VAS score obtained from all patients 
immediately after recovery from anesthesia, at 2hr, 4hr, 6hr, 8hr, 10hr, 12hr, and 24hr post-operative.
Results: Postoperative VAS score was significantly lower in the three groups (GC, G, and C) 
respectively when compared with group O. Discussion: Spinal procedures are associated with high 
level of postoperative pain compared to other surgical procedures and the majority of patients report 
moderate to severe pain, which persists for at least initial 3-4 days. Recommendation: Based on the 
the current study we recommend: Usage of primitive multimodal analgesic with the various mechanism 
of action is more useful in post-operative pain relieve after major surgery.