Sixty adult patients with thoracic or lumbar vertebral body fractures undergoing minimally invasive posterior stabilization were randomized to receive either an erector spinae plane (ESP) block with levobupivacaine (n=28) or a placebo saline injection (n=28). The primary outcomes were opioid consumption and Visual Analogue Scale (VAS) pain scores over 48 hours postoperatively. Secondary outcomes included perioperative blood loss, Oswestry Disability Index (ODI), Patient Reported Outcome Spine Trauma (PROST), and wound complications, assessed up to four weeks post-surgery. Overall, the results revealed significantly lower morphine use during the immediate postoperative period in the ESP group, lower average VAS scores during the first 24 hours, and improved PROST scores on days 2 and 28. No significant differences were seen in ODI, total 48-hour morphine use, or wound complications. These findings suggest that ESP block is effective in reducing early postoperative opioid requirements and improving short-term outcomes.