TLIP Block Versus Retrolaminar Block on Quality of Recovery After Posterior Lumbar Spine Fusion Surgery

NCT07609212 | Not Yet Recruiting

• 1 other identifier: TLIP-RLB-QoR-2026
• Study Type: interventional
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective randomized controlled study aims to compare the effects of ultrasound-guided thoracolumbar interfascial plane (TLIP) block versus retrolaminar block on postoperative quality of recovery in patients undergoing posterior lumbar spine fusion surgery. Despite advances in surgical techniques, lumbar spine fusion is associated with significant postoperative pain, which may delay recovery and increase opioid consumption. Recent approaches emphasize multimodal analgesia and opioid-sparing strategies, including regional anesthesia techniques. Interfascial plane blocks, such as TLIP and retrolaminar block, have gained attention due to their safety and effectiveness in targeting the dorsal rami of spinal nerves supplying the posterior spinal structures. The primary outcome of this study is postoperative quality of recovery assessed using the Quality of Recovery-15 (QoR-15) questionnaire at 24 hours. Secondary outcomes include pain scores, opioid consumption, time to ambulation, time to oral intake, and postoperative complications.

Conditions

Postoperative Pain; Spinal Fusion Surgery; Degenerative Lumbar Spine Diseases

Keywords

TLIP Block; Retrolaminar Block; Regional Anesthesia; Quality of Recovery; QoR-15; Lumbar Spine Surgery; Postoperative Analgesia

Outcome Measures

Primary Outcomes (1)

• Quality of Recovery-15 (QoR-15) score at 24 hours postoperatively

  Quality of recovery will be assessed using the Quality of Recovery-15 (QoR-15) questionnaire, a validated 15-item patient-reported outcome measure. Scores range from 0 to 150, with higher scores indicating better postoperative recovery. The primary endpoint is the QoR-15 score at 24 hours after surgery.

  24 hours postoperatively

Secondary Outcomes (7)

• Pain intensity using Visual Analog Scale (VAS)

  30 minutes, 2, 6, 12, and 24 hours postoperatively

• Time to first rescue analgesia

  Within 24 hours postoperatively

• Total nalbuphine consumption

  24 hours postoperatively

• Time to first ambulation

  From end of surgery to first ambulation, assessed up to 48 hours postoperatively

• Time to tolerate oral intake

  From end of surgery to first tolerated oral intake, assessed up to 48 hours postoperatively

Study Arms (2)

Thoracolumbar interfascial plane Block Group

EXPERIMENTAL

Patients will receive ultrasound-guided thoracolumbar interfascial plane block after induction of general anesthesia.

Procedure: Thoracolumbar interfascial plane block

Retrolaminar Block Group

EXPERIMENTAL

Patients will receive ultrasound-guided retrolaminar block after induction of general anesthesia.

Procedure: Retrolaminar block

Interventions

Retrolaminar block PROCEDURE

Ultrasound-guided injection of local anesthetic posterior to the vertebral lamina at the L3 level.

Retrolaminar Block Group

Thoracolumbar interfascial plane block PROCEDURE

Ultrasound-guided injection of local anesthetic into the fascial plane between the multifidus and longissimus muscles at the L3 level

Thoracolumbar interfascial plane Block Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult patients aged 18-65 years
• Male and female patients
• Scheduled for elective one- or two-level posterior lumbar instrumented fusion surgery under general anesthesia
• ASA physical status I-III
• BMI \< 35 kg/m²
• Willing to participate and provide informed consent

You may not qualify if:

• Patient refusal to participate
• Coagulopathy or anticoagulant therapy
• Infection at the site of block injection
• Known allergy to local anesthetics
• Chronic opioid use (\>3 months)
• Severe hepatic, renal, or cardiac dysfunction
• Neurological deficits interfering with pain assessment
• Pregnancy or lactation

Sponsors & Collaborators

• Assiut University: lead

Study Sites (1)

Assiut University Hospitals

Asyut, Egypt

Location

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Central Study Contacts

Rehab Mohamed Mostafa Mahmoud, MD (Candidate)

CONTACT

+201063303791; rehab.mohamed19@gmail.com

Mohamed Abo Elhassan, MD (candidate)

CONTACT

+201001311044; Aboelhassan@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: This is a double-blind study where participants and outcome assessors are blinded to group allocation. The anesthesiologist performing the block is not blinded. Identical dressings are applied to maintain blinding.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Lecturer of Anesthesia, Intensive Care, and Pain Management

Model Details: Participants will be randomly assigned to one of two parallel groups: TLIP block group or retrolaminar block group.

Study Record Dates

• First Submitted: April 20, 2026
• First Posted: May 27, 2026
• Study Start: June 1, 2026
• Primary Completion (Estimated): June 1, 2027
• Study Completion (Estimated): June 1, 2027
• Last Updated: May 27, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)