abalin are analogues of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) and are frequently used as adjuncts in multimodal anesthesia strategies for managing acute pain. However, the opioid-sparing effect of gabapentinoids in the context of spine surgery has yet to be consistently demonstrated. Materials and Methods. The PearlDiver database was queried from 2010 to 2021 for patients who underwent primary one to three levels ALIF with posterior fixation. Patients with opioid or gabapentinoid use within six months before index surgery were excluded. Patients with both gabapentinoid and opioid treatment were propensity score matched to patients with opioid-only treatment. Results. The propensity score-matching resulted in two equal groups of 2617 patients with and without adjunctive gabapentinoid treatment for pain management. Adjunctive use of gabapentinoids was associated with a modest 2.9% reduction in average morphine milligram equivalent (MME) per day [standardized mean