Combinations of various nonopioid analgesics have been used to decrease pain and opioid consumption postoperatively allowing for faster recovery, improved patient satisfaction, and decreased morbidity. These opioid alternatives include acetaminophen, NSAIDs, COX-2 specific inhibitors, gabapentinoids, local anesthetics, dexamethasone, and ketamine. Each of these drugs presents its own advantages and disadvantages which can make it difficult to implement universally. In addition, ambiguous administration guidelines for these nonopioid analgesics lead to a difficult implementation of standardization protocols in spine surgery. A focus on the efficacy of different pain modalities specifically within spine surgery was implemented to assist with this standardized protocol endeavor and to educate surgeons on limiting opioid prescribing in the postoperative period. The purpose of this review article is to investigate the various opioid sparing medications that have been used to decrease morbidity in spine surgery and better assist surgeons in managing postoperative pain. Methods. A narrative review of published literature was conducted using the search function in Google scholar and PubMed was used to narrow down search criteria. The keywords “analgesics,” “spine,” and “pain” were used.

ResumoApresentamos um caso único de um homem de 56 anos que deambulou com um espaçador cimentado para quadril durante 11 anos. Após ser submetido a uma hemiartroplastia em virtude de um acidente de carro, o paciente desenvolveu uma infecção articular periprotética (IAP) vários anos depois, sendo submetido à técnica de revisão da etapa 1. Com a resolução da infecção depois da etapa 1, o paciente recusou a segunda etapa, devido à satisfação com o espaçador cimentado por quase 11 anos.Pelo que sabemos, este é o caso mais longo relatado de um espaçador cimentado em um paciente deambulando. Este caso demonstra a confiabilidade mecânica dos espaçadores cimentados reforçados com metal que podem ser mantidos por um prazo longo em pacientes selecionados.