We explored the effects of methotrexate (MTX), a well-known folic acid antagonist, in addressing epidural fibrosis (EF), a common complication that can lead to persistent back pain after lumbar surgery. In our study, we tested how topical application of MTX influenced the healing process following lumbar laminectomy in rats, an experimental model for understanding back pain post-surgery.
Our results were promising—the use of MTX seemed to significantly suppress the development of EF compared to the control group. We measured this through various methods, including macroscopic scoring, hydroxyproline content analysis, and histological evaluations. Additionally, we observed that the effectiveness of MTX was dose-dependent, increasing with higher concentrations.
We also investigated the underlying mechanisms and found that the effects of MTX might be linked to endoplasmic reticulum (ER) stress, which appeared to trigger cell apoptosis in fibroblasts. This suggests that MTX could potentially help in regulating scar formation which is often at the root of chronic back pain.
Overall, our findings indicate that while MTX does not target folate directly, its therapeutic properties may offer a new avenue for managing post-surgical back pain through its effects on EF and associated cellular pathways.
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