A Prospective Study to Compare Bupivacaine and Exparel Versus Bupivacaine or Exparel Alone for Postoperative Pain Relief

Inclusion Criteria:

1. Age 18 or older;

2. Primary indication is low back pain, lumbosacral radiculopathy, lumbar disc
degeneration, lumbar disc herniation, stenosis, spondylolisthesis, spondylolysis, or
deformity requiring surgical intervention;

3. Scheduled to undergo primary, 1 or 2 level, posterior lumbar laminectomy with or
without fusion, discectomy with fusion, or fusion at Virtua Memorial Hospital;

4. Willing to provide informed consent, participate in study, and comply with study
protocol.

Exclusion Criteria:

1. Hypersensitivity or allergy to local anesthetics;

2. Pregnant or contemplating pregnancy prior to surgery;

3. Previous surgery in lumbar spine (i.e. other than microdiscectomy);

4. Prior treatment for alcohol, recreational drug, or opioid abuse;

5. Serious spinal conditions (e.g. spinal cord compression, cauda equina syndrome, spinal
infection, spinal tumor, spinal fracture, inflammatory or systemic spinal arthritis);

6. Surgery involving more than 2 vertebral levels;

7. Worker's compensation or personal injury related to lumbar spine (treatment outcomes
may be affected by patient's personal interests [21]; could also run into potential
issues with reimbursement).

8. Lactating women

9. Patients with end stage liver disease