Objective To discuss the application effect of Pender′s health promotion model combined with operating room comprehensive thermal insulation nursing in elderly patients undergoing spinal surgery. Methods A total of 83 elderly patients who underwent spinal surgery in Guangzhou Liwan District Orthopedic Hospital from November 2019 to May 2020 were selected as research projects. According to the random number table method, the patients were divided into control group (42 cases) and observation group (41 cases). The control group was intervened with routine nursing combined with operation routine thermal insulation measures, while the observation group was intervened with Pender health promotion model combined with comprehensive thermal insulation nursing in operating room. The nasopharyngeal temperature, incidence of postoperative shivering, cognitive level and negative emotion changes before and after intervention were compared between the two groups during perioperative period (30 min before operation, 30 and 60 min during operation, 30 min after operation). Results There were statistically significant differences in nasopharyngeal temperature time, inter-group and interaction effects between the two groups (F=22.157, 25.803, 39.175, P＜0.05). The nasopharyngeal temperature at 30 and 60 min during opertation, and 30 min after operation in the control group were lower than that at 30 min before operation, with statistically significant differences (P＜0.05). While, there were no significant differences in the temperature of nasopharynx in the observation group at 30 and 60 min and 30 min after operation compared with that at 30 min before operation(P＞0.05). And the nasopharyngeal temperature at 30 and 60 min and 30 min after operation in the observation group were higher than those in the control group, with statistically significant differences (P＜0.05). There were 9 cases of postoperative shivering in the control group and 2 cases in the observation group, and the incidence of postoperative shivering in the observation group was lower than that in the control group, with a was statistically significant difference(P＜0.05). After intervention, the score of mini mental sate examination (MMSE) in the observation group was higher than that in the control group, and the score of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) in the observation group were lower than those in the in the control group, with statistically significant differences (P＜0.05). Conclusion Pender′s health promotion model combined with operating room comprehensive thermal insulation nursing is conducive to body temperature of patients during spinal surgery, which can significantly reduce the incidence rates of postoperative chills and postoperative cognitive dysfunction, and relieve the patients′ negative emotions.