The goal of this project was to determine risk factors for carpal tunnel syndrome (CTS) in spine surgeons. Members of the North American Spine Society participated in a questionnaire survey in the Spring of 2004. There were 107 reported cases of CTS. The authors observed a linear dose response (p < .01) between hours of work and CTS. Predictors were obesity (body mass index > or = 30; adjusted odds ratio [OR] = 2.04, 95% confidence interval [CI] = 1.11-3.76) and practicing surgery for > 5 years (adjusted OR = 4.24, 95% CI = 1.54-11.69). The authors identified the use of the Kerrison rongeur (a bone-removal tool) as the greatest ergonomic risk for the surgeons (adjusted OR = 2.72, 95% CI = 1.54-4.81), and 37% of them reported that CTS interferes with their work. Ergonomic interventions for CTS should be evaluated in the operating room.