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Abstract Background Post discectomy discitis is regarded as the most disabling cause of failed back surgery. Value of local intra-operative application of antibiotics in prevention of such complication has been a matter of debate. We evaluate the role of intraoperative intra-discal vancomycin powder instillation as a prophylaxis in prevention of postoperative discitis in patients undergoing microscopic discectomy. We allocated 100 patients undergoing discectomy equally into two groups. In the first group, a local Vancomycin powder was inserted into the disc space after finishing discectomy, and in the second group, nothing was inserted. Results The postoperative discitis was reported in 6 cases; of them, two patients were in the Vancomycin group (4%), while four patients were in the non-Vancomycin group (8%). Conclusions We concluded that the intra-operative prophylaxis, with intra-discal Vancomycin, decreased the incidence of postoperative discitis but without significant statistical difference. We advocate using local vancomycin especially in high risk patients for prevention of post discectomy discitis.

Background: Low-back pain is a major health and economical problem that affects populations around the world. Chronic low-back pain, in particular, is a major cause of medical expenses, work absenteeism, and disability. Objective: To explore the effect of adding cognitive-behavioral therapy to physical therapy interventions in patients with chronic non-specific back pain. Patients and methods: 20 male and female patients between 25 and 40 years old diagnosed as chronic non-specific back pain with central sensitization and fear avoidance behaviors symptoms participated in this study. Patients were randomly assigned into two groups. The first group was treated by cognitive behavioral therapy (graded exposure and graded activity) in addition to physiotherapy the second group was treated by physical therapy interventions which was given only 3 times/week for 4 consecutive weeks. Results: Descriptive statistics was used to identify each variable's mean and standard deviation. A paired t-test was used to compare characteristics of patients between both groups. Pre-treatment results showed no significant difference in both measured variables of Oswestry, and pain in both groups (P > 0.05). On the other hand, post-treatment results showed a significant decrease in the Oswestry, and pain only in group A (the study group). Conclusion: Adding graded exposure and graded activity as an operant cognitive behavioural therapy approach to physical therapy program is more beneficial than physical therapy program alone. More data and follow up needed for this study. [ABSTRACT FROM AUTHOR]