Informed consent for surgery implies that a patient has a comprehensive understanding of the procedure as well as its indications, potential risks, benefits, and available alternatives. Traditionally, consent is obtained through a dialogue between the surgeon and patient in which the surgeon must attempt to convey the intricacies of surgery in a way that best facilitates patient education and understanding. Within the context of spine surgery, this inherently challenging task is made more difficult by unfamiliar anatomical language and rigid time constraints that may shorten the duration of this vital conversation. The use of extended reality holds the potential to further enhance patient understanding, retention, and expectations of surgery within the narrow preoperative counseling window. This randomized, non-blinded clinical trial will be the first to comprehensively compare the effectiveness of headset-based AR for preoperative spine surgical counseling to conventional preoperative counseling methods. We will evaluate outcomes in terms of patient satisfaction, confidence in the surgeon, post-operative pain levels, pre-operative anxiety, knowledge assimilated by the patient, retention rates, and the rate of new patient referrals.