Post-operative pain following spinal surgery remains a daily challenge, with numerous management strategies proposed, none of which have achieved widespread consensus. The most conventional approach involves infiltration of paravertebral musculature and cutaneous tissues; however its efficacy remains uncertain [1]. A variety of alternative, particularly pharmacological interventions, have been explored with mixed results. Yet, no standardized approach has emerged within the surgical community [2], [3], [4]. It appears, indeed, that there are no surgery (or postoperative pharmacological management) related risk factors for chronic postoperative pain; the only identified risk factors are patient-related factors, such as anxiety, depression, pain catastrophizing, pain sensitivity and preoperative opioid consumption [5]. Regarding the latter point, a significant postoperative opioid consumption has been reported in some studies as a predictive factor for persistent pain [6]. In this context, we present our preliminary observations on the use of a novel preventive treatment protocol, based on preoperative botulinum toxin infiltration directly into the intended surgical site.