BACKGROUND Patients with spinal cord injury (SCI) commonly experience varying degrees of anxiety, depression, and sleep disturbances, which may hinder postoperative recovery. AIM To examine the association between postoperative anxiety-depression symptoms, injury severity, and sleep quality in patients with SCI. METHODS A total of 149 patients who underwent surgical treatment for SCI from December 2021 to December 2024 were enrolled. At three months postoperatively, all participants were assesse