Use of Ultrasonic Bone Scalpel in Adolescent Idiopathic Scoliosis

The primary purpose of this randomized trial is to compare the efficacy of an ultrasonic bone scalpel (or osteotome device) with standard of care surgical instruments during posterior spine fusion with instrumentation.

Ultrasonic Bone Scalpel, Adolescent Idiopathic Scoliosis, Posterior Spinal Fusion, Estimated Blood Loss

Surgeons will use the ultrasonic bone scalpel, to their discretion, along with standard of care manual devices when performing the posterior spinal fusion.

Surgeons will use, to their discretion, only standard of care manual devices when performing the posterior spinal fusion.

Number of Patients With Intraoperative and Postoperative Blood Transfusions in the Ultrasonic Bone Scalpel Group and Standard of Care Group

This outcome measure measures the number of patients with intraoperative and postoperative blood transfusions placed in the Ultrasonic Bone Scalpel Group and the Standard of Care Group.

Intraoperative, Short Term Postoperative (end of procedure until hospital discharge, up to 7 days after surgery)

Cobb angle is a measurement of the degree of side-to-side spinal curvature used to define Scoliosis. A Cobb angle of 10 degrees is the minimum angle to define scoliosis. Angles of 40-50 degrees or more may require corrective surgery. Cobb angle will be measured from postoperative radiographs

Lenke Type 1 is a main thoracic curve pattern, and is the most common pattern observed in cases of adolescent idiopathic scoliosis (AIS). The Lenke Classification System provides surgeons with a simple, accurate, and reproducible way to communicate about scoliosis. It relies on measurements taken from standard x-rays. The surgeon evaluates the x-ray from the front, side, and in bending positions. Each scoliosis curve is then classified in three ways: by the curve type based on the three regions of the spine, a lumbar spine modifier, and a sagittal thoracic modifier. The classification system combines the curve type (1-6) with the lumbar modifier (A, B, C) and the sagittal thoracic modifier (-. N, +) to form the complete classification.

Inclusion Criteria: 10-18 years of age Diagnosis of Adolescent Idiopathic Scoliosis (AIS) Scheduled for a posterior spinal fusion (without Schwab Grade II or higher osteotomy) Exclusion Criteria: Plan for a posterior column osteotomy of Schwab Grade II or higher Prior spinal surgery Magnetic Resonance Imaging (MRI) abnormalities (such as syrinx and/or chiari malformations) Subjects with medical comorbidities (e.g. heart, lung, kidney disease) Subjects with bleeding diatheses Non-idiopathic etiology for scoliosis