Aim of study The objective of the current study is to compare the efficacy of ultrasound-guided bilateral modified thoracolumbar interfascial plane (TLIP) block versus erector spinae (ES) block in optimizing early quality of recovery (QOR) following lumbar spine surgery under general anesthesia.

Lumbar spine surgery, a common surgical procedure to alleviate spinal stenosis or disc herniation, is often associated with significant postoperative pain that can hinder early recovery and patient satisfaction. Effective pain management is critical to improve the quality of recovery (QOR), reducing complications, and facilitating early mobilization (1). Regional anesthesia techniques, such as nerve blocks, have gained popularity as part of multimodal analgesia strategies to minimize opioid use and enhance postoperative outcomes. Among these, the thoracolumbar interfascial plane (TLIP) block and the erector spinae (ES) block have emerged as promising ultrasound-guided techniques for managing pain after lumbar spine surgeries (2).

Inclusion Criteria:

• Patient scheduled for elective lumbar spine fixation 2-3 levels.
• American Society of Anesthesiologists(ASA) class I-III.

Exclusion Criteria:

• 1. Obese patients (Body Mass Index> 35). 2. Patients with neurological deficits, cardiopulmonary disease, hepatic or renal impairment.

  3. Patients with history of severe allergies to local anesthetics or other medications used during the procedure.

  4. Patients with history of coagulation disorder or anticoagulants. 5. Patients with emergency surgeries or re-do surgeries. 6. Patients with systemic infections or infections at the site of injection. 7. Patients with Psychiatric illnesses. 8. Patients with history of drug addiction