Gliomas, one of the most severe malignant tumors of the central nervous system, have a high mortality rate and an increased risk of recurrence. Therefore, early glioma diagnosis and the control of treatment have great significance. The blood plasma samples of glioma patients, patients with skull craniectomy defects, and healthy donors were studied using terahertz time-domain spectroscopy (THz-TDS). An analysis of experimental THz data was performed by machine learning (ML). The ML pipeline included (i) THz spectra smoothing using the Savitzky–Golay filter, (ii) dimension reduction with principal component analysis and t-distribution stochastic neighborhood embedding methods; (iii) data separability analyzed using Support Vector Machine (SVM), Random Forest (RF), and Extreme Gradient Boosting (XGBoost). The ML models’ performance was evaluated by a k-fold cross validation technique using ROC-AUC, sensitivity, and specificity metrics. It was shown that tree-based ensemble methods work more accurately than SVM. RF and XGBoost provided a better differentiation of the group of patients with glioma from healthy donors and patients with skull craniectomy defects. THz-TDS combined with ML was shown to make it possible to separate the blood plasma of patients before and after tumor removal surgery (AUC = 0.92). Thus, the applicability of THz-TDS and ML for the diagnosis of glioma and treatment monitoring has been shown.

Currently, several materials for the closure of the dura mater (DM) defects are known. However, the long-term results of their usage reveal a number of disadvantages. The use of antibiotics and chitosan is one of the major trends in solving the problems associated with infectious after-operational complications. This work compares the mechanical properties of samples of bacterial nanocellulose (BNC) impregnated with Novochizol™ and vancomycin with native BNC and preserved and native human DM. An assessment of the possibility of controling the mechanical properties of these materials by changing their thickness has been performed by statistical analysis methods. A total of 80 specimens of comparable samples were investigated. During the analysis, the results obtained, the factor of Novochizol™ addition has provided a statistically significant impact on the strength properties (Fisher Criteria p-value 0.00509 for stress and 0.00112 for deformation). Moreover, a stronger relationship between the thickness of the samples and their ultimate load was shown: $R^2=0.236$ for BNC + Novochizol™ + vancomycin, compared to $R^2=0.0405$ for native BNC. Using factor analysis, it was possible to show a significant effect of modified chitosan (Novochizol™) on the ultimate stress (p-value = 0.005).

Background. Despite its long history, cranioplasty remains a topical problem of neurosurgery, due to the increasing number of traumatic brain injury, the consequences of which are the main driver in preserving the population of patients with postcranioectomy skull defects. As a rule, these defects are extensive, and the use of individual implants in these cases is the method of choice. Over the past 5 years, the use of products created by medical additive manufacturing has increased, in this regard, the assessment of long-term results of surgical interventions with their use is an actual issue of modern medicine.Aim. To evaluate the results of surgical treatment of patients with skull defects of various etiologies using individual titanium implants made by three-dimensional printing.Materials and methods. The study analyzed 94 cases of cranioplasty using individual titanium implants made by three-dimensional printing using DMLS (Direct Metal Laser Sintering) technology. The minimum follow-up period was 12 months from the moment of the intervention. Traumatic brain injury and its consequences was the dominant cause of skull bone defects (n = 56, 59.6 %). The average area of defects in the study group was 99.2 ± 43.4 cm². For men (n = 53), this parameter corresponded to 106.7 ± 44.7 cm², for women (n = 41) – 89.5 ± 40.1 cm².Results. The total number of complications in the study group was 12 (12.7 %) cases, of which 5 (5.3 %) cases were recorded during the in hospital stay of patients, 7 (7.4 %) – during outpatient follow-up. One complication was not related to the performed surgical intervention. Removal of the implant was required in 7 (7.4 %) cases. The terms of implant removal varied from 0 to 14 months from the moment of the performed intervention. The survival rate of individual titanium implants for more than 12 months was 92.6 %.Conclusion. The data on the presence of complications after cranioplasty vary from study to study, while the results of reconstructive interventions performed using individual titanium implants are of significant interest, the use of which has increased significantly over the past five years due to the introduction of additive medical production into clinical practice.

Цель исследования – на основе комплексного анализа клинических данных оценить эффективность бипортальной эндоскопической хирургии в сравнении с традиционными методами микродискэктомии у пациентов с грыжами межпозвонковых дисков. Для достижения этой цели следовало решить ряд задач: сопоставить ключевые операционные показатели (длительность вмешательства и объём интраоперационной кровопотери) в группах бипортальной эндоскопии и стандартной микрохирургии; оценить степень и динамику болевого синдрома после выполненной операции по визуально аналоговой шкале через 1, 3 и 12 месяцев после операции; на основе индекса Освестри (Oswestry) оценить функциональное восстановление пациентов для объективной оценки уровня повседневной активности; сравнить продолжительность госпитализации в обеих группах, чтобы выявить потенциальные экономические и организационные преимущества минимально инвазивного подхода; изучить частоту послеоперационных осложнений и рецидивов грыж межпозвонковых дисков в отдалённом периоде для оценки безопасности и долгосрочной эффективности; разработать предварительные критерии отбора пациентов, позволяющие максимизировать клинические результаты применения бипортальной эндоскопической хирургии. Средняя длительность операции и кровопотеря при использовании методики бипортальной эндоскопической хирургии для удаления грыж межпозвонковых дисков уменьшается более чем на 40% по сравнению с традиционными открытыми методами микрохирургии. Послеоперационная боль по шкале VAS снижается в 2,5 раза, по индексу ODI состояние больных улучшается более чем на 60%. Средняя длительность госпитализации составляет 2,1 суток против 5,4 суток в группе сравнения. Частота рецидивов грыж межпозвонковых дисков при бипортальной эндоскопической хирургии не превышает 3,5%. Реализация поставленных задач позволит обосновать целесообразность внедрения бипортальной эндоскопической хирургии позвоночника в клиническую практику, определить место бипортальной эндоскопической хирургии в алгоритме лечения дискогенных патологий позвоночника, сформировать доказательную базу для проведения дальнейших мультицентровых исследований в этой области.

The dura mater plays a key role in protecting the central nervous system by providing mechanical and barrier functions. Various injuries, surgical interventions, and pathological conditions may require its repair or replacement. The use of synthetic implants or autografts often carries risks, including infections, allergic reactions, and rejection. In recent years, bacterial cellulose has gained attention as a biomaterial with unique properties that could significantly improve surgical outcomes. This review explores the potential of bacterial cellulose as a dura mater substitute and analyzes its advantages. A literature search was conducted in PubMed and Google Scholar (2014–2024), focusing on key studies of biocompatibility and neurosurgical applications. Keywords included bacterial nanocellulose, properties of bacterial nanocellulose, dura mater defects, biocompatibility. Out of 127 sources (in vitro, in vivo, and clinical studies), 32 articles were selected based on novelty, depth of research (mechanical properties, immune response, tissue regeneration), and relevance to dura mater repair. Priority was given to publications from the last decade (2014–2024), experimental in vivo models (rabbits, rats), and reviews on neurosurgical applications. A literature review has shown that bacterial cellulose is a promising biomaterial with unique properties, including high biocompatibility, hypoallergenicity, and the ability to modulate the immune response toward an anti-inflammatory phenotype. A key factor in its efficacy is thorough endotoxin removal, which minimizes inflammatory reactions. Bacterial cellulose demonstrates particular potential in experimental and clinical neurosurgery as a potential medical device for dura mater defect repair.

Today, various fluorescent methods are widely used for intraoperative diagnosis of malignant brain tumors. However, all of them rely on exogenous fluorophores. Meanwhile, UV-induced autofluorescence may also be of interest. The aim of the study was to identify characteristic spectra of glioblastoma tissues using ultraviolet laser-induced fluorescence spectroscopy. Material and methods.  Morphological and laser fluorescence studies were conducted on resected glioblastoma tissues from three patients. Microscopy and morphometry with hematoxylin and eosin staining were employed. Using a tunable wavelength laser (210–290 nm), excitation-emission matrices of laser-induced fluorescence were measured. Results and discussion.  Principal component analysis (narrow peak method) enabled the identification of three component spectra contributing to the fluorescence of the samples. These components correspond to different forms of tryptophan, with intensity maxima at wavelengths of 315 nm and 330 nm, and connective tissue. The primary malignant brain tumors studied were significantly heterogeneous; however, the ratio of the intensities of the fluorescent components differs for samples with varying tissue elements content – tumor parenchyma, necrotic parenchyma, and stromal elements. Conclusions.  Spectral changes associated with tryptophan fluorescence, quantitatively determined by the ratio of the intensities of the above-described components, can be used as a new biomarker for glioma and may serve as the basis for developing an optical, minimally invasive method for determining tumor boundaries.