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This article aims to describe the development of a head support for prone spinal surgery, which allows the patient's head to be positioned in neutral alignment with the body and enables monitoring of the position of the eyes, mouth, nose, and orotracheal tube, thus avoiding damage due to poor positioning during surgery. A literature review was conducted focusing on complications resulting from head positioning in different supports to develop an option that would reduce the risks of injury. It was developed a support that protects the patient's head and allows easy visualization of the face during surgery, with sufficient space for the anesthesia team to manage the orotracheal tube if necessary. Since its creation, no serious complications have been observed in the use of this support.