Salient Aquamantys Spine Trial

Inclusion Criteria: 1. Be candidate for three level (or greater) fusion surgery from T1 to S1 utilizing a direct posterior approach 2. Male or female 18 to 70 years of age (inclusive) 3. Must sign the IRB approved Informed Consent Form Exclusion Criteria: 1. Undergoing spinal fusion for \< 3 lumbar levels, or using an approach other than direct posterior 2. Undergoing an interbody fusion 3. Planned use of hypotensive anaesthesia 4. Pregnant or lactating 5. Morbid obesity, defined as Body Mass Index (BMI) greater than 40 6. Previously diagnosed coagulopathy or bleeding diasthesis 7. Currently, or within the previous 7 days prior to surgery, taking any medications that would produce bleeding diathesis including, but not limited to NSAIDs, aspirin, clopidogrel (Plavix), ticlopidine, or valproic acid 8. History of significant cardiac disorders that would necessitate special fluid management protocols 9. Serious trauma other than that confined to the spine 10. History of acute myocardial infarction and/or acute angina within the past year prior to enrollment 11. PT/INR \>1.3 in the 14 days prior to surgery 12. PTT \> 40 in the 14 days prior to surgery 13. Platelet count \<100K in the 14 days prior to surgery 14. Based on clinical history, physical exam and subject presentation, subject has or is suspected to have a history of alcohol and/or drug abuse that would preclude subject from providing adequate consent and/or complying with study requirements 15. Prisoner or transient 16. Enrolled in another drug or device investigational study (currently or within past 30 days) 17. Unable or unwilling to sign the Informed Consent Form or comply with protocol specified procedures