It is well established that psychological factors can affect spine surgery results. A widely utilized presurgical psychological screening (PPS) algorithm that combines established psychosocial risk factors to determine patients' likelihood of achieving successful spine surgery results is evaluated in this study. Patients ( = 603) underwent a PPS, including a diagnostic interview, psychometric testing, and review of medical records. The evaluator completed a PPS algorithm for patients, placing them into one of five prognosis categories, ranging from excellent to poor. For analysis purposes, these categories were collapsed into three prognosis groups: Excellent, Good, and Fair to Very Poor. Patients classified as having an Excellent prognosis achieved the best outcomes following surgery, whereas those in the Fair to Very Poor category obtained the worst results. Analyses of specific components of the PPS algorithm demonstrated that algorithm items were modestly associated with reduced spine surgery results. Implications for presurgical assessments of spine surgery candidates are discussed.