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A cross-sectional study.To analyze the relationship between resilience, acceptance, coping, and adjustment to spinal chronic pain.Several studies have concluded that resilience is relevant in predicting pain and physical functioning among patients with chronic pain. Although resilience may have a role in preventing or living with chronic pain, there is little research on the effects of resilience on adjustment among patients with chronic pain.Multivariate multiple regression by structural equation modeling was performed to simultaneously determine the influence of all the predictor variables on all the dependent variables. The sample was composed of 299 patients (138 men and 161 women) suffering from chronic spinal pain.Higher levels of resilience were associated with higher levels of pain acceptance and active coping strategies. Active coping and acceptance were associated with higher levels of adjustment to pain.Positive personality characteristics could play a crucial role in patient adjustment, and thus clinicians should take into account the positive path to capacity to better understand the chronic pain experience.