Cancer remains a significant global health issue in the 21st century, accounting for 16.8% of all deaths and 22.8% of noncommunicable disease (NCD) deaths globally. This study investigated the impact of a novel integrated rehabilitation intervention on clinical and psychosocial outcomes in cancer patients with vertebral metastasis. The three-year study included newly diagnosed oncological patients or those undergoing treatment, aged 18 years or older, with vertebral metastasis and spinal pain. The intervention was tailored to each patient based on mental and functional reserves, risk of vertebral fractures, physical reserves, fatigue, and ongoing oncological therapy. The control and experimental groups were compared in terms of baseline characteristics, physical activity, tumor characteristics, pain, sphincter disorders, complications, survival, functional scores, and coping mechanisms. The experimental group demonstrated significantly better outcomes, including longer mean survival time (3.5 vs. 2.8 years, < 0.001), higher Barthel Total Score (60.7 vs. 40.8, = 0.002), and lower prevalence of fractures (20.0% vs. 55.4%, < 0.001), osteoporosis (17.0% vs. 37.0%, = 0.001), anemia (22.2% vs. 57.4%, < 0.001), and vomiting (6.1% vs. 54.5%, < 0.001). The experimental group also exhibited a lower reliance on avoidant coping strategies (29.0 vs. 31.3, < 0.001). The study provides robust evidence that a personalized rehabilitation intervention significantly improves survival, functional independence, and coping strategies in cancer patients with spinal bone metastasis.