Protective Effects of Methotrexate and Tenoxicam in Peridural Fibrosis in Rat Laminectomy Model

Abstract

Objective: Peridural fibrosis after laminectomy is an important surgical problem. Tenoxicam is a nonsteroidal antiinflammatory drug and an oxicam derivative acting by inhibiting the formation of prostaglandin and eicosanoids. Low dose methotrexate which has been used as an antiinflammatory agent rhomatoid arthritis inhibits the synthesis of potentially toxic compounds those accumulate in inflamed tissues. The aim of this study was to evaluate and compare the efficacy of these two independent pharmacological agents in the inhibition of peridural fibrosis. Methods: L3-4-5 bilateral laminectomy with sparing the dura mater integrity was perfomed to 30 male Wistar albino rats. Except the SHAM group, low dose methotraxate (0.2 mg/kg) or tenoxicam (0.5 mg/kg) was administered on the dura mater before the surgical closure. After 42 days, all rats were euthanized and their spinal columns performed laminectomy were removed for the histopathological evaluation. Results: The peridural fibrosis grades of the groups administered low dose methotrexate or tenoxicam were lower than SHAM group grades. They have lower fibroblast counts than SHAM group numerically, although there was no statistically significant difference among groups. Conclusion: Local usage of low dose methotrexate and tenoxicam may be helpful option for prevention of peridural fibrosis after laminectomy procedures in future.