- Perhaps more so than in any other surgical specialty, patient positioning is a critical component of neurosurgical procedures. Whereas most other surgeries are performed in the supine position with little input or assistance from the anesthesiologist, positioning for neurosurgical procedures requires cooperation between the surgeon, anesthesiologist, and nursing staff. Correct patient positioning is essential to ensure adequate surgical access, surgeon comfort, and minimal risk for patient injury. There are several positions commonly employed for neurosurgical procedures. It is essential that all operating room personnel have a comprehensive understanding of the various positions employed for neurosurgical procedures, as well as the unique risks and possible postoperative implications associated with that position.