Ostene in Thoracolumbar Decompression and Fusion Evaluated With VIBE

* Patients will be screened prior to surgery for inclusion and exclusion criteria. * If eligible, patients will be approached in the preoperative area or clinic location to consent or refuse participation in the study. * Baseline characteristics will be collected via a combination of patient preoperative survey and manual chart review. * Patients will undergo the normal surgical standard of care, receiving Ostene intraoperatively as determined appropriate by the attending spine surgeon during the procedure. * It is anticipated that Ostene will be used specifically during the bony work/laminectomy phase preceding decompression. Of note, this material is now considered standard of care by our principal investigator and would be used regardless of study participation. * Other hemostatic agents will be used according to the typical standard of care. * A trained research coordinator will be present to determine VIBe scores during 6 key surgical phases: 1) exposure, 2) bony work/laminectomy, 3) decompression, 4) instrumentation, 5) fusion, and 6) closure. Agreement will be obtained from the operating surgeon. * For all phases, the maximum VIBe score during each phase will be recorded. * Surgical information will be documented from the operative note. * Patients will receive the normal standard of care postoperatively including measure(s) of their hemoglobin/hematocrit and postoperative drain output. * Data on postoperative outcomes/complications will be collected from the electronic medical record. * A propensity-score matched cohort analysis will be constructed to compare patients who received Ostene to patients who did not receive Ostene (will use data from past study conducted from 2021-April 2023 to construct matched control cohort). * There will be no group assignment in this study * There will be no placebo group or randomization * Patient data from a past study will be used as a control comparator