Longitudinal recovery trajectories in spine oncology following spine surgery using patient-reported outcomes (PROs)

Spine oncology patients often experience a multidimensional symptom burden beyond pain. Despite improvements in survival outcomes, changes in patients’ physical and psychosocial domains following spine tumor surgery remains poorly characterized, and minimal clinically important differences (MCIDs) in this complex group have not been established. Patient-Reported Outcomes (PROs) of adult patients undergoing spine tumor surgery between 2023 and 2025 were measured using PROMIS-29 questionnaires. Longitudinal trajectories were described and modeled using linear mixed-effects model. MCIDs were calculated in subpopulations stratified by baseline pain severity. Physical and psychosocial symptoms are heavily interconnected. Pain intensity correlated most strongly with pain interference (ρ = 0.80) and physical function (ρ = 0.54). Patients with high baseline pain (≥ 4) were more likely to achieve MCID despite greater overall symptom burden. Pain improved significantly within 3 months postoperatively; however, it does not synchronously transform into functional improvement. Recovery trajectory varied across domains and subgroups, while a biphasic pattern of early improvement followed by transient worsening that later improved or stabilized was observed across multiple domains. Recovery following spine tumor surgery is domain-specific and dynamic. Baseline pain level delineates both symptom profiles and recovery pattern, which needs to be considered in counseling patients. Multidisciplinary management involving both functional rehabilitation and psychosocial intervention are needed.