Fifty-two adolescents with thoracic adolescent idiopathic scoliosis were randomized to receive either Ponte osteotomies (n=26) or no osteotomies (n=26) during posterior spinal fusion using pedicle screw instrumentation. The primary outcome of interest was radiographic curve correction. Secondary outcomes included surgical time, blood loss, and complications. Outcomes were assessed using pre- and postoperative radiographs and perioperative clinical data. Overall, the results of the study revealed that Ponte osteotomies were associated with significantly improved thoracic kyphosis restoration but not with enhanced coronal plane correction. Surgical time and blood loss were significantly higher in the PO group. These findings suggest that while Ponte osteotomies may improve sagittal alignment, they come at the cost of increased surgical morbidity.