Pathological conditions of the spine treated with surgical intervention include intervertebral disk disease, spinal stenosis, scoliosis, spondylosis, spondylolisthesis, kyphosis and lordosis, tumors and trauma. The number of these procedures has increased exponentially in the United States as a consequence of the low back pain epidemic, aging population, and development of less invasive surgical techniques. It is imperative that anesthetists be familiar with the challenges associated with these procedures including prone position, fluid shifts, prolonged surgeries and manipulations adjacent to nerves and major blood vessels. General anesthesia is the most common technique for surgery of the spine, although regional anesthesia is a potential option for lumbar microdiskectomy or laminectomy.