Seventy-eight patients undergoing lumbar spinal surgery were randomized to receive either volume-controlled ventilation (VCV, n=26), pressure-controlled ventilation (PCV, n=26), or pressure-controlled ventilation-volume guaranteed (PCV-VG, n=26). The primary outcome of interest was peak inspiratory pressure (Ppeak) and plateau airway pressure (Pplato). Secondary outcomes included dynamic lung compliance (Cdyn), arterial oxygen pressure (PaO2), and arterial oxygen saturation (SaO2). Outcomes were assessed at seven time points from the supine to prone position during surgery. Overall, the results of the study revealed that PCV-VG provided lower Ppeak and Pplato values and higher Cdyn, PaO2, and SaO2 compared to the other two modes. These findings suggest that PCV-VG may be a superior ventilation mode for prone-position lumbar surgery in terms of both lung protection and oxygenation.