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Objective: To explore the clinical effect of posterior decompression screw and spinal canal decompression fixation on patients with thoracic spinal cord injury. Methods: A total of 54 patients with thoracic pulp injury were selected and divided into control group (27 cases) and study group (27 cases) by random number table method. The control group was treated with posterior decompression laminae screw, and the study group was treated with spinal canal decompression fixation. Relevant surgical indexes of the two groups were analyzed. Serum inflammatory factors were detected. Visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the degree of pain and dysfunction in the two groups. Frankel scale was used to evaluate the spinal cord injury of the patients, and the postoperative effects of the two groups were compared. Results: Compared with the control group, the operation time, intraoperative blood loss, surgical incision and hospital stay in the study group were reduced, with statistical differences (all P<0.05). 1 and 3 months after surgery, compared with the control group, the decrease degree of interleukin1B (IL-1β), tumor necrosis factor-a (TNF-α), VAS and ODI scores in the study group was more significant, and the increase degree of Frankel grade was more significant, with statistical difference (all P<0.05). Compared with the control group, the clinical effect of the study group was more significant, with statistical difference (P<0.05). Conclusion: The treatment effect of spinal canal decompression and fixation for patients with thoracic spinal cord injury is good. After treatment, the inflammatory level of patients is reduced, pain is relieved, and motor function and nerve function are restored. The overall effect is significant, which is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

Objective To investigate the safety and efficacy of acute hypervolemic hemodilution (AHH) combined with controlled low central venous pressure (CLCVP) in posterior spinal surgery. Methods From February 2021 to January 2022, a total of 60 patients who underwent elective posterior spinal surgery in this hospital were selected, and the American Association of Anesthesiologists classified them as Grade Ⅰ-Ⅱ. They were randomly divided into group C (AHH combined with CLCVP) and group F (routine infusion), with 30 cases in each group using the randomized numerical table method. After entering the room, the patients in both groups were monitored by radial artery puncture and central venous puncture (CVP) under local anesthesia. Routine anesthesia was induced, and perioperative infusions and medications were managed using CLCVP anesthesia techniques. The infusion volume, bleeding volume, urine volume, blood transfusion volume, operation time and nitroglycerin dosage of the two groups were recorded. And the mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2), hemoglobin (Hb), hematocrit (Hct), CVP, blood glucose, blood lactate, Hemagglutination indexes [including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg) and platelet count (Plt)], blood gas analysis [including pH, partial pressure of carbon dioxide (PCO2), partial pressure of oxygen (PO2), arterial oxygen saturation (SaO2) and alkali residue (BE)] at each time point before anesthesia induction (T0), at the beginning of skin incision (T1), at the beginning of operation (T2), at the end of operation (T3), at the end of operation (T4) and at the first day after operation (T5) were recorded. Perioperative adverse reactions, complications and steward score during recovery also were recorded. Results The operation time in group C was shorter than that in group F and the dosage of nitroglycerin was higher than that in group F, but the differences were not statistically significant (P＞0. 05). The infusion volume and urine volume in group C were significantly higher than those in group F, and the bleeding volume, plasma and suspended red blood cells were significantly lower than those in group F, with statistical significances (P＜0. 05). Compared with T0, the average arterial pressure and heart rate in the two groups were significantly decreased from T1 to T3, the Hb and Hct in group C were significantly decreased from T1 to T4, the CVP and platelet count were significantly decreased, and the PT and APTT were significantly prolonged from T1 to T3. The Hb in group F was significantly decreased from T2 to T5, and the Hct was significantly decreased from T3 to T4, with statistical significances (P＜0. 05). Compared with group F, the Hb in group C decreased significantly at T1, increased significantly at T5, the Hct at T1, CVP decreased significantly from T1 to T3, the PT and APTT prolonged significantly from T1 to T3, with statistical significances (P＜0. 05). There were no significant differences in perioperative adverse reactions, complications and steward score between the two groups (P＞0. 05). Conclusion AHH combined with CLCVP can be safely used in posterior spinal surgery which has a good blood protection effect. It can significantly reduce the amount of intraoperative bleeding and allogeneic blood transfusion, maintain the stability of hemodynamics and internal environment during operation, and keep stable recovery period, without increasing perioperative adverse reactions and complications. At the same time, CLCVP is conducive to providing a clear surgical field and shorten the operation time. [ABSTRACT FROM AUTHOR]