ObjectiveTo compare the effects of surgical and non-surgical treatments on long-term psychological condition and pain control in patients with metastatic spinal tumors.MethodsUsing Zung’s Self-Rating Anxiety Scale, Zung’s Self-Rating Depression Scale, and Numerical Rating Scale, we examined patients with metastatic spinal tumors at diagnosis and 1, 3, 6, and 9 months after surgery (diagnosis) both surgical and non-surgical treatment groups.ResultsA total of 216 patients were enrolled in the present study, with 101 in the surgery group and 115 in the non-surgery group. There were no significant differences in the anxiety, depression or pain between the two groups at diagnosis. Anxiety and depression were relieved in both groups from the third month after surgery (diagnosis) to the ninth month after surgery, with the scores being significantly lower in the surgery group than those in the non-surgery group (P=0.000). The mean score of pain decreased to (1.2±0.9) in the surgery group and to (6.4±2.0) in the non-surgery group after a period of 9 months. Patients in the surgery group had significantly lower pain scores in the last four assessments compared with the non-surgery group after surgery (diagnosis) (P=0.000).ConclusionSurgical treatment is superior than non-surgical treatment in reducing anxiety and depression and controling pain in patients with metastatic spinal tumors.