Randomized Controlled Comparison of Pre-op TLIP vs Intra-op TLIP

Inclusion Criteria: * greater than or equal to 18 years of age on the date of service * require a 1 to 3 level posterior laminectomy with fusion * compliant with study requirements and outpatient follow-up * a daily MME less than 25 MME per day in the per-operative period Exclusion Criteria: * younger than 18 years of age on the date of service * does not consent to participating in the program or to be refusal to follow-up at 2-3 weeks, 4-6 weeks, and 3 months post-operatively * requiring revision surgery at the same level for posterior laminectomy with fusion * a daily MME score \>25 MME/day in the pre-operative period will be excluded * a positive drug screen for cocaine and/or tetrahydrocannabinol (THC), defined in the standard Corewell Drugs of Abuse Screening as cocaine \> 300 ng/mL and cannabinoid \> 50 ng/mL-any * ongoing lawsuits, workers compensation, and litigation will be excluded.