To compare the pain relief in spine surgery from a pain killer drug (Ropivacaine) with a placebo (Normal Saline) delivered regionally at the transverse process of the operated vertebrae.

Back surgery involving spinal hardware (instrumentation) — such as screws, rods, and cages — is known to cause significant pain in the days after the operation. Managing this pain well is important not just for comfort, but to help patients breathe deeply, move, and recover more quickly. This study is testing whether placing an absorbable gelatin sponge soaked in the local anaesthetic ropivacaine on the bony parts of the spine (the transverse processes) at the end of surgery can reduce pain and the need for strong opioid painkillers afterward. Participants will be randomly assigned to receive either the ropivacaine-soaked sponge or an identical sponge soaked in plain saline (the placebo), with neither the patient nor the care team knowing which was used. Pain scores and opioid use will be tracked for 48 hours after surgery. You may be eligible if you are between 18 and 75 years old and scheduled to undergo spinal instrumentation surgery under general anaesthesia. People who have had previous spinal surgery at the same level, are having surgery for a spinal tumour, or have an allergy to local anaesthetics are not eligible. This study is being conducted in Lebanon and offers a safe, non-invasive approach to potentially improving post-operative pain management.