Materials and methods. Chitosan-based films were made out of 3% solution of chitosan for the research. We used 200, 500 and 700 kDa chitosan (deacetylation rate 80-90 %) to produce chitin-chitosan membrane by using solvent evaporation method. For enhancing mechanical properties and reducing the degradation, chitin particles were added to the chitosan solution. Chitosan and chitin ratio was 80/20. The chitin/chitosan solution in Petri dishes was dried out during 3 days at room temperature. To obtain information about the structure of membrane surface and crosssection scanning, electron microscopy was performed. Hydrolytic degradation was studied by pouring into SBF solution. To determine the rate of enzymatic degradation, trypsin solution was used. To determine the mass loss percentage, we measured the sample weight after 7, 14, 21, 30 and 60 days after being in the appropriate solutions. Relative elongation and strength were measured by digital dynamometer to study membranes mechanical properties such as the strength and elasticity. MLO-A5 cells were used to assess biocompatibility of new materials. Results. Macroscopic view of obtained samples has shown their relative transparency with impregnation of chitin particle that elevated over the membrane surface without any diversity between different chitosan molecular weight samples. Due to scanning electron microscopy, principal diversity between the samples of different molecular weight has being seen: rough pore surface at 200 and 500 kDa and flat with minimal roughness surface of 700 kDa membranes. Cross-section of 500 and 700 kDa membranes are dense with no pores, but 200 kDa membrane are sponge like and it can be prediction for fluid sorption and cell migration during healing process. Chitin-chitosan membranes are biocompatible and degrade in aqueous and enzymatic solutions. Due to polysaccharide nature of chitosan and chitin, enzymatic degradation has shown higher trend compare to the hydrolytic ones. 200 kDa membrane degrades faster with final mass loss 83.2 % and completely due to porous structure that allows fluid sorption. Membrane mechanical parameters strongly depend on their structure. 200 kDa membrane has shown 2-fold higher elongation compared to 500 kDa and 3-fold-compared to 700 kDa ones. The compensation of mechanical forces ensured by porous structure is better than in dense ones. Tensile strength was in 2-fold better in 200 kDa membranes than in 500 and 700 kDa ones. Cell culture experiment has shown the better adhesion at the 3 rd day for 200 kDa membrane and minimal cell adhesion for 700 kDa membrane, probably due to smooth surface. The reduction rate between all samples and PCT control differ a lot, except for 200 kDa membrane that has the same proliferation rate as TCP. Conclusion. Chitin-chitosan membranes, made from different molecular weight chitosan, are transparent and has appropriate structure for being used as a dura mater substitute. They are biocompatible and degrade in aqueous and enzymatic solutions. Due to porous structure, excel...

Objective. To study cerebrospinal fluid (CSF) changes after the duraplasty with autologous fascia, collagen-based material and chitin-chitosan membrane in early and late postoperative periods.Materials and methods. Chitosan-based films were made out of 3 % solution of chitosan for the research. We used 200 kDa chitosan (deacetylation rate 80-90 %) to produce chitin-chitosan membrane by using solvent evaporation method. For enhancing mechanical properties and reducing the degradation, chitin particles were added to the chitosan solution. Chitosan and chitin ratio was 80/20. The chitin/chitosan solution in Petri dishes was being dried out during 3 days at room temperature.Cerebrospinal fluid composition has been studied after the duraplasty with autofascia, collagen-based material and innovative chitosan-based graft in early and late postoperative periods. The duraplasty was performed by applying these materials to 90 Chinchilla rabbits breed. Animals were divided into three groups: I group -duraplasty using the fascia lata autograft, II group -duraplasty with the collagen-based material, III group -duraplasty using the chitin-chitosan membrane. The animals in the II and III groups were divided into 2 subgroups: A -plasty without fixing the material, B -plasty with fixing the material using atraumatic suture. CSF composition was studied before and after the operation had been performed in 2 weeks, 2 and 6 months. Results.The results of our study demonstrated the increase in density and protein level, the decrease in рН and glucose level and the extreme increase of cells, mostly neutrophils after the use of fascia lata for dural closure. At the same time, there were no substantial changes after dural closure with artificial collagen-and chitosan-based materials, the CSF composition normalized in 2 months after operation.Conclusion. The use of autologous fascia for duraplasty leads to an acute response of the cerebrospinal fluid in the early postoperative period and to residual pleocytosis. The chitosan-based graft application was followed by no complications at 6 months after surgery and only slight CSF response in the early postoperative period. There wasn't any significant difference in CSF composition in chitosan-and the collagen-based material usage. Given the lack of changes in SCF tests between suture and no suture graft fixation except for a slight increase in erythrocyte number in the early postoperative period, the choice of material fixation method is entirely dependent on the clinical situation and does not affect the cerebrospinal fluid state.

Introduction. Degenerative disc disease is one of the most common diseases of the musculoskeletal system, characterized by dystrophic changes in the intervertebral disc and vertebral bodies adjacent to it. The main symptoms of this disease are pain and sensory and motor disorders, which, according to various authors, occur in 50–80% of adults. The main objective of the study was to find and implement the optimal set of treatment measures for degenerative disc disease depending on the age of a patient. Materials and Methods. The medical records of inpatients who were treated in the Neurosurgical Department of the Sumy Regional Clinical Hospital in 2019–2020 were analyzed. The course of treatment of 93 patients (61 men and 32 women) was studied. The patients were divided into groups according to their age: young age (under 25) – 13 men and 8 women; middle age (under 60) – 24 men and 19 women; and elderly age (over 60 years) – 18 men and 11 women. The combined use of pathogenetically justified physiotherapeutic measures in the treatment complex is gaining more and more interest. Their distinctive features are physiologic nature, absence of allergic manifestations, the ability to influence most of the pathogenesis of the disease, and the organic combination with other therapeutic factors. Unfortunately, there is an increase in the incidence of temporary incapacitation and progressive course, which often leads to disability and significant financial costs associated with expensive modern methods of diagnosis, treatment, and further provision of employment to patients. The results of our study show that complex treatment including pathogenetic drug therapy, complex paravertebral block, therapeutic physical exercise, and physiotherapy treatment methods provides adequate recovery of spinal function regardless of dystrophic and degenerative changes severity and patient's age. Treatment of degenerative disc disease should be comprehensive and directed at the various symptoms and links of the pathological process.