Researchers conducted a retrospective study. They sought to determine the prognosis and characteristics of patients with colorectal cancer (CRC) spine metastases undergoing surgical treatment. Because the prognosis of patients with spinal metastases from non–small cell lung cancer (NSCLC) was well-studied, the outcomes of these individuals were compared to those of patients with non–small cell lung cancer (NSCLC). The study comprised 155 patients who had surgical treatment for spinal metastases from CRC (n=35) or NSCLC (n=120) between 2010 and 2018. Throughout the disease, data were collected on all cancer-related treatments for both the initial malignancy and the spinal metastases. Patient, tumor, and therapy parameters were split into categorical variables, and postoperative survival durations were compared between the CRC and NSCLC groups. The average time from cancer diagnosis to spinal metastasis in the CRC group (32.5 months) was substantially longer than in the NSCLC group (12.9 months). Concurrent spinal metastasis was more common in the NSCLC group (45.0% vs 17.2%; P=0.003) than in the CRC group. CRC patients had higher visceral metastasis than NSCLC patients (77.1% vs 42.5%; P<0.001). The proportion of patients receiving postoperative systemic treatment in the NSCLC group was substantially greater than in the CRC group (59.2% vs 20.0%) (P<0.001). After spine surgery, the median survival time was 4.2 months in the CRC group and 5.8 months in the NSCLC group (P=0.015). After surgical therapy for CRC spinal metastases, the prognosis was worse than in the NSCLC group. The later development of spinal metastases and the local opportunity of postoperative medical treatment in CRC spinal metastasis could explain the outcomes.