Whether blood transfusion is needed for posterior open cervical spine surgery is decided according to the patient’s condition, if there is no obvious blood loss no blood transfusion is needed, and blood transfusion treatment is needed for serious blood loss. Posterior open cervical spine surgery usually refers to posterior cervical spine surgery, this surgery is more damaging to soft tissue and muscle, especially the spinal canal enlargement and shaping surgery through the vertebral plate decortication after the bleeding increased significantly, there is a possibility of postoperative electrolyte disorders and hyponatremia, severe anemia, and even hemorrhagic shock, need for blood transfusion. In clinical practice, suspended red blood cells are usually transfused when blood loss exceeds 20% or hemoglobin is less than 70 grams per liter to correct blood loss and improve blood volume. Whether or not to transfuse blood in posterior open cervical spine surgery is subject to the surgeon’s opinion.