Objective To observe the effect of self-management program based on Cox Health Behavior Interaction (COX-IMCHB) theory on functional recovery of patients after lumbar fusion. Methods A total of 178 patients with underwent lumbar fusion surgery form Jurong People's Hospital from January 2022 to December 2023 were selected and divided into groups according to their admission time, with 89 cases in each group. The control group received nursing interventions, while the Cox-IMCHB group received self-management interventions based on the Cox-IMCHB theory in addition to the basic nursing interventions. incidence of complications, the Oswestry Disability Index (ODI) before and after nursing, the Japanese Orthopaedic Association (JOA) scores, the on the Self-Care Ability Scale (ESCA), the Barthel Index (BI) scores, the Short Form-36 (SF-36), and the satisfaction with nursing services were compared between the two groups. Results The complication rate was lower in the Cox-IMCHB group than in the control group (P<0.05). ODI score was lower and JOA score was higher in Cox-IMCHB group than control group after care (P<0.05). ESCA scores and BI scores were higher in the Cox-IMCHB group than in the control group after care (P<0.05). SF-36 score was higher in Cox-IMCHB group than control group after nursing care (P<0.05). Satisfaction with nursing service was higher in Cox-IMCHB group than control group (P<0.05). Conclusions Self-management program based on Cox-IMCHB theory can promote the recovery of lumbar function, enhance the ability of daily living, improve the quality of life of patients, reduce postoperative complications, and improve the satisfaction of patients with nursing services after lumbar fusion.