Introduction: Lumbar spine surgery is one of the most frequently performed spinal procedures worldwide. Both general anesthesia (GA) and spinal anaesthesia (SA) are widely used and considered safe, but comparative evidence regarding intraoperative and postoperative outcomes, surgeon satisfaction, and cost effectiveness remains limited.

Material and Method: This was a double‑blinded, quasi‑experimental prospective study of 84 patients, randomized into two equal groups (GA: 42, SA: 42), conducted between June 2016 and June 2025. Patients underwent single‑ or two‑level discectomy, laminectomy, or laminoforaminotomy for lumbar disc herniation or lumbar canal stenosis. Parameters recorded included heart rate (HR), mean arterial pressure (MAP), blood loss, total anesthetic time, post‑anesthesia care unit (PACU) time, surgeon satisfaction, analgesic and antiemetic requirements, cost of anesthesia, and hospital stay.

Results: Baseline demographic characteristics, HR, and MAP were comparable between the two groups. The SA group demonstrated significantly shorter mean anesthetic time, reduced PACU stay, lower postoperative analgesic and antiemetic requirements, and reduced anesthesia‑related costs compared with the GA group (p < 0.05). Although intraoperative blood loss, operative duration, and hospital stay varied between groups, these differences were not statistically significant. No major anesthesia‑related complications were observed in either group.

Conclusion: Spinal anesthesia is as safe and effective as general anesthesia for lumbar spine surgery. It provides shorter anesthetic and recovery times, reduced analgesic and antiemetic requirements, fewer complications, and greater cost effectiveness, making it a valuable alternative to GA in appropriately selected patients.