Objective <p>This study aimed to evaluate the effectiveness of whole-course high-quality nursing care combined with individualized nutritional intervention in patients undergoing spinal surgery during the perioperative period.</p> Methods <p>In this single-center, single-blind randomized controlled trial, patients were assigned to receive either routine perioperative care or whole-course high-quality nursing care combined with individualized nutritional intervention. Outcomes included pain level (visual analog scale, VAS), functional recovery (Berg balance scale, BBS), 6-min walking distance (6MWD), nutritional status (albumin, total protein), activities of daily living (ADL), quality of life, incidence of complications, and nursing satisfaction.</p> Results <p>Compared with the control group, the intervention group had significantly lower VAS scores, higher BBS scores, longer 6MWD, and improved albumin and total protein levels (all <i>P</i> &lt; 0.05). ADL and quality-of-life scores were higher in the intervention group, accompanied by greater nursing satisfaction and a lower incidence of postoperative complications (<i>P</i> &lt; 0.05).</p> Conclusion <p>Whole-course high-quality nursing management combined with nutritional intervention effectively improves pain control, functional recovery, nutritional status, daily living ability, and quality of life while reducing postoperative complications and improving nursing satisfaction in patients undergoing spinal surgery.</p>