Setting the tone: The music spine surgeons listen to in the OR


Music is an important part of people's daily lives, and for surgeons the right playlist can help set the grounds for a confident, successful surgery.

Eleven spine surgeons shared their operating room rituals, whether it includes a full soundtrack or silence.

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker's invites all spine surgeon and specialist responses.

Next week's question: Think about a time in your life when you were a spine or orthopedic patient, whether for surgery or not. What stood out in your experience?

Please send responses to Carly Behm at by 5 p.m. CDT Wednesday, Sept. 20.

Editor's note: Responses were lightly edited for clarity and length.

Question: Do you listen to music in the OR? If so, which albums or songs do you like best?

Paul Bagi, MD. Kayal Orthopaedic Center (Franklin Lakes, N.J.): I do listen to music in the OR, and I've often been told I play the best songs. It's important to keep the atmosphere light, and music helps with that. If you come in my room you'll hear 2000s hip hop, and there's always at least one head bobbing to a Dr. Dre beat.

Jeremy Denning, MD. Dallas Neurosurgical & Spine (Plano, Texas): We listen to music a lot. Generally speaking, listening to music has a calming effect on everyone in the OR, and that's very helpful. What we listen to varies, depending on who's in the OR — sometimes it's classical music, sometimes it's country, or classic rock — I usually let the OR staff pick their favorite genre. It doesn't really matter to me what the music is as long as it has the desired effect!

Chester Donnally, MD. Texas Spine Consultants (Dallas): On Spotify I listen to a famous playlist known as "Spine Music Festival 2" or the Spotify Radio version of it. I make a new playlist once I get 100 new songs. Both have a bit of a following! But honestly, sometimes I get sick of EDM. I usually tell the nursing staff they can pick whatever they want. It's their OR also and I usually can't even hear the music. Really, I'm just trying to introduce them to the latest and greatest in EDM!

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: I have built a pretty extensive playlist on streaming. It's very eclectic, and runs the gamut of electronic, rock, house, blues, folk, soul and standards. It's inspired by the music that's been my life since I was young. It's also an homage to important people in my life who've inspired and taught me over the years. My dad loves music, and there was nary a Saturday afternoon when George Harrison, the BeeGees, or Marvin Gaye were not on the stereo. I make sure the volume is not too loud and we can all work clearly and safely. Without fail nursing staff, anesthesia, scrub techs and even reps work so much better with a good playlist. It is without a doubt a mood setter, and keeps everyone moving and upbeat. It always makes me happy when I see people Shazam songs or follow my playlist. 

Arun Hariharan, MD. Paley Orthopedic and Spine Institute (West Palm Beach, Fla.): Absolutely, music is a key part of my OR routine! It's not only enjoyable but also helps create a focused and positive atmosphere during surgeries. I find that energetic and upbeat music, much like Avicii's style, contributes to maintaining concentration and keeping a steady rhythm during procedures.

Tracks like "Wake Me Up," "Levels," and "Broken Arrows" are classics. Other artists, like Calvin Harris, Kygo and Illenium are also often heard in my OR. The dynamic nature of this music complements the fast-paced nature of the operating room and helps me stay in the zone.

There are moments during surgeries when stopping the music and capturing the attention of the room becomes crucial. In these instances, I pause the music to ensure everyone in the room is fully engaged and aware of critical steps or decisions that need to be made.

The right music truly makes a difference, helping me stay focused and providing a sense of flow throughout the surgical process. It's all about finding the right balance between the uplifting power of music and the need for clear communication during crucial phases of surgery.

Richard Kube II, MD. Prairie Spine & Pain Institute (Peoria, Ill.): I never have listened to music in the OR. In addition to the standard array of anesthesia and X-ray machines and other white noise in the OR, we have an added air conditioning unit to keep the room cool for those of us standing in lead under lights all day. Music would further add to the white noise, and in my opinion, make communication more challenging in my OR. We are working under microscope or image guidance frequently, so most communication is without eye contact. I just like to hear everything that is going on in the room and know that everyone can easily hear me.

Todd Lanman, MD. ADR Spinal Restoration Center (Beverly Hills, Calif.): 

I do not listen to music in the operating room. I like my operating room quiet, actually. I don't like distractions or anything that takes my focus away from the patient. I remind everyone in my operating room that everyone there is there for the patient. I do not want them talking about their weekend. I don't want them talking about their evenings or shopping lists or scrolling through Instagram. I want them all focused on the surgery. It's our duty to do that and we are all better together doing that. Music and socializing are great, but not in the OR.

Ali Mesiwala, MD. DISC Sports & Spine Center (Newport Beach, Calif.): I listen to everything from hip-hop to heavy metal. I have no favorites but choose playlists that reflect the mood of the team who is working with me that day. If the patient has a preference, we always play that until they are fully anesthetized and then switch it up.

Michael Oh, MD. UCI Health (Irvine, Calif.): I always have music in the OR and believe that it enhances the working environment, but it can also be a distraction. I have a playlist that is specifically designed for opening, mid portions, and closing of my spine cases at UC Irvine. My opening playlist is from the Guardians of the Galaxy soundtrack vol. 1 and vol. 2.

I have been playing this for four years straight. Because of that consistency, there is a Pavlovian response and with the first chords, everyone in the room is alert to the start of the case and focused with happy music.

For the mid-portions of the case that involve more attention, instrumentation and decompression, instrumental music is preferred (especially Windham Hill/George Winston).  This is played at low volumes not to distract from the key portions of the surgery.

After confirmation with final X-rays and correct sponge counts, the closing music begins:

Rock the Casbah mix from the Clash starts an upbeat and energetic mood to move the surgery to a finish.

Krishna Satyan, MD. Dallas Neurosurgical & Spine: Every physician has their own preference when it comes to music in the operating room. Some surgeons do not like any music at all. Some surgeons like to blast music. Personally, I enjoy a low level of classic rock music playing in the background. It is not distracting and calms the mind while operating, allowing me to focus on the task at hand.

Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Our music listening is limited to closing time only. And my choice is almost exclusively '80s rock and glam metal. Van Halen, Guns N' Roses, Journey, ZZ Top,  Bon Jovi, Sting and the like, and on occasion a big hair band may grace the airwaves. Albeit the younger staffers do listen to more contemporary music while setting up the room and cases, this is quickly extinguished prior to the anesthetic administration and time out. We have also memorialized the fallen rockers of this genre by playing their bands' music as a tribute. Unfortunately, this practice has become more frequent of late.   

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