Objective To evaluate the effectiveness of quintuple prehabilitation nursing intervention model in perioperative anxiety and pain management for patients undergoing idiopathic scoliosis (IS) spinal orthopedic surgery. Methods A retrospective analysis was conducted on 80 patients with IS who underwent spinal orthopedic surgery at Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou from May 2022 to May 2025. According to the different nursing modalities, the patients were divided into a control group and a study group, 40 cases in each group. The control group received routine perioperative nursing, while the study group was administered a quintuple prehabilitation nursing intervention in addition to the routine care. Perioperative anxiety [self-rating anxiety scale (SAS)], postoperative pain [visual analogue scale (VAS)], analgesic requirements, and functional recovery indicators were compared between the two groups. Results There were no significant differences in preoperative SAS total scores or subscale scores between the two groups (all P > 0.05). At postoperative day 3, the study group demonstrated significantly lower SAS total scores and scores for all subscales compared with the control group (all P < 0.05). The VAS scores of the study group patients at each postoperative time point were significantly lower than those of the control group at the corresponding time points (all P < 0.05). The proportion of patients in the study group who received additional analgesic drugs within 48 hours after surgery was significantly lower than that in the control group (P < 0.05), and the length of hospital stay was also significantly shorter (P < 0.05). Conclusion The quintuple prehabilitation nursing intervention model significantly alleviates perioperative anxiety and pain for patients undergoing spinal orthopedic surgery for IS, promotes early functional recovery and improves rehabilitation efficiency.