80 patients with symptomatic lumbar 4-5 stenosis undergoing posterior lumbar interbody fusion (PLIF) were randomized to receive either preemptive multimodal analgesia (celecoxib, pregabalin, oxycodone ER, and acetaminophen) or standard postoperative intravenous morphine. The purpose of this study was to compare pain in the immediate postoperative period and radiographic outcome up to one year after surgery. Results demonstrated significantly reduced VAS pain and ODI scores in the preemptive analgesia group compared to control at all follow-up points (excluding POD 1, where ODI scores were similar). There was no difference in rate of complications or non-union between groups