Objective: To explore the application effect of a phased nursing guidance program in early rehabilitation training for patients after minimally invasive spinal surgery, providing references for clinical rehabilitation nursing. Methods: A total of 148 patients who underwent minimally invasive spinal surgery in our hospital from July 2023 to June 2025 were selected as the study subjects. They were randomly divided into an observation group and a control group using a random number table method, with 74 cases in each group. The control group received conventional nursing guidance after minimally invasive spinal surgery, while the observation group implemented a phased nursing guidance program. The pain levels (VAS scores), spinal function (JOA scores), quality of life (SF-36 scores), rehabilitation training compliance, and complication rates of the two groups of patients at different postoperative time points were compared. Results: At 7, 14, and 30 days postoperatively, the Visual Analogue Scale (VAS) scores in the observation group were significantly lower than those in the control group (all p < 0.001). At 7, 14, and 30 days postoperatively, the Japanese Orthopaedic Association (JOA) scores in the observation group were significantly higher than those in the control group (all p < 0.0001). Moreover, the JOA scores in both groups gradually increased over time, with a more pronounced increase observed in the observation group. At 30 days postoperatively, the scores in all dimensions of the Short Form-36 (SF-36) scale in the observation group were significantly higher than those in the control group (all p < 0.001). The compliance rate with rehabilitation training in the observation group was 95.95%, significantly higher than the 82.43% in the control group (χ² = 7.008, p < 0.05). The complication rate in the observation group was 4.05%, significantly lower than the 14.86% in the control group (χ² = 5.049, p < 0.05). Conclusion: The phased nursing guidance program can effectively alleviate pain, improve spinal function and quality of life, enhance compliance with rehabilitation training, and reduce the incidence of complications in patients after minimally invasive spinal surgery, making it worthy of clinical promotion and application.