The number of spinal operations performed in the United States has significantly increased in recent years. Along with these rising numbers, there has been a corresponding increase in the number of patient comorbidities. It is critical to consider a patient’s co-morbid health conditions when planning surgery.  We put together a team of residents to review the current literature for a variety of co-morbidities, including obesity, older age, substance use, mood disorders, diabetes, rheumatoid arthritis, osteopenia/osteoporosis, heart disease, and kidney disease.  The review outlines specific recommendations for management of each co-morbidity in the peri-operative period and also highlights the need for further higher-level prospective studies.

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