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`VolumeZ/Issued—November20H .
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`Evidence-Based Spine-Care Journal
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`EDITORIAL
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`CONTACTS
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`\-’11|111111-11 1.1111’1 -— _-‘Ull
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`This material was copied
`at the NLM and may be
`Subject USCapvright Laws
`
`

`

`I.rr'1h'.'.h'.w.rm.f\ Ifl'nhnu' Maxed 'q-wn‘ um- leum'
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`IIIIII'I}I
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`IIIIII'III
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`EBSJ
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`Evidence-Based Spine—Care Journal
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`
`
`VOLUME 2. ISSUE 4
`
`MESSAGE FROM THE EDITOR
`
`9—?
`
`HM P Hvlmv: rx- inlrnu- in [law norm of u'it'nu-J
`
`.h'm' L'Impnmn
`
`
`
`SCIENCE IN SPINE—FUNDAMENTALS
`
`9-”
`
`I'lnhdllilily. pr'rml, uml x'lilliull sigmeulnu'
`Amh'm (I .S'kt’Hy
`
`
`
`ORIGINAL RESEARCH
`
`H—IH
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`I’Lllvlt't-r'k l1 [ulnunm vilm I\ :1” :lvgvm‘l'aliw dim; nlmumt
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`
`
`SYSTEMATIC REVIEWS
`
`27-33
`
`35-43
`
`th‘h pain-Ill hiainl'y and pl'lyximi mumilmliuu: [ltl‘EIItl MRI |1|L1H'll
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`45—50
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`55—56
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`P’IL’I' Leu'kmu'd, Christian P DEPHUM, Run-m: .St'hmm'n, Murry! Unnmk, (.‘Jnn‘h’x 0' Fffi'ht'!’
`
`—_————————
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`‘39
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`This material may be protected by Copyright law (Title 17 us. Code)
`
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`

`

`ID
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`IIIL' inhvri‘nl \-'(ll'i£|l'iilily] nl IIH‘ L'H‘linhmr. TJH‘ In‘nccs‘w gt‘l‘lL‘l'i‘lIt‘E-u a “It-xi retali‘ulic'” \’i'l|l1t'
`tlml in llll’ll nwii In dvn-rr'ninv lin' prnhnhilily :11 having Ulllilillml lin‘ I‘Q'Nllll hy t'lmnu‘
`{lillt'ri sampling t‘l'l'nl'l .1lnm'.T|H'P valllt’ i5 Illt' prm'mi'ufh'iv Illdl the nlisvrvt'd llilk'l't'llt'l'
`wunld Ilnlipt'li i1 HII’ mil] prnllnwix nl' I1n .stnt'ialinn was Irnv.
`
`i5 IIIJI Iiu' calm‘rvrtl ilii'li‘l‘trnt'i‘ is (int llH'lldlll‘t' wily.
`‘\I.IIi'»1il .it Irula llt‘lII ~1an Inn hnw lilu'iy il
`o
`Hu- -.|u.:|iri Iln'
`i" mlnv, 1hr Ivar- liiu'h,r 1 lml lht' rc'xnil nhlnim'd Hill“! 110 dln' In {immu-
`II 1hr nnli ln-‘Iilllllt'fii'u Wu" II'ln'.
`
`-
`
`Jln- !‘ mlm- I‘» nannlly tnnnmrc'd will'i .‘In nl'liitl'dry lellt' In {‘mlllali' alal ixliml 5i},-
`niln .nu t'
`liv l iIlH'l'IIIIlIH, illia lt'wl ni sl-IIiwlk-nl aignilimm'i- in usually .li'i and rur—
`l‘...4..,,1.I-.1n1ln- pinlmhiiilynl i'i'it'rling lilt' null hypullu'his‘ win-n nn msm'iniinn
`II'.I||\_ l"‘.|l'~ In -I||I'Il Iln' illilllnl nI' Iwn'
`1 t’rrnra.
`
`I.II|11|I'|iIH'|i'iIIll"Illlllllypulill'fii‘ntint".HillIll‘u'fi'hdl'ilyllIl’.III||I-|l1|Ii‘15xllt'i-ilitllih
`11H‘ul'nl.l Il-.I'\’\'|"<l‘.Il‘it‘flllilllllllll'IIIIHIIVIHiII'Il‘Wi“ih't'fi'lh'fHI‘H'ASHF'NI’"f'i'rll'l'pllhllIlll‘il‘w'
`-.n. “nun; i--.,i-.I~., Illil iIm-u I1 rnmli Ill-II Ilu’ rrl-IIInn-Jnl: inmnmll lilhillt’l' Iln' Inllnwinit'
`o
`III-\r‘|1<llllill1|Itl.{I'dll‘vlllJIllI'{It’llllllI-rllfily'V’I-lllll"'||IIIHII)![Ili'Illlll'llililll‘Il-llllll‘l’
`“4. Inny'e’mni
`IIIII illl'.l'f\-'l'
`.I Ilillt'lt'lll {'
`III nlln'i manila. m- will Ili‘ WIinn: ILHlliinl'a.
`[in-iv .m- ril'n'i IliTH". wlwn Wt’ HUFIiIHII Iin‘ Inlll |1\,']||1[|lt"ij'i l-vln'n il
`in Lilac nullmi
`
`o
`
`Itn- |Hir II III iu'ln t‘ilill]. In f|1I*.t.I‘-(‘ WI' tin rInI lilni .i 'nLIIIhlilx’ unznilimlll Iinllnn:
`win-n{In-n-I':'.i||\_-'ix.1{hilt-Imu-
`
`\"(llllilit' li’lhsm' .-1 — JI'II I
`
`This materialwas copied
`at the NLM and may be
`Subject US Copyright Laws
`
`

`

`\{ I'I‘Irri' m .sirr'rrl'
`
`-I'raI'raI"I'liI_I'. want, and I limurl .xl'lairr'fic'aml'
`
`n
`
`The results are statistically significant: why isn‘t that enough?
`WIIiII- t‘\-'.'IllI-1|lllll nl 1|n- l' valnv againsl Ihis arlIiIrary Illlllllll‘l' nl .Il'i may lil'li\'it|l’ mnn‘
`gllirlarni' will] I'l"‘|lt't'| In Il'n‘ I'Ult' nl aanmling v.1 rialiilily a mi ramlnm L'rrnr,
`r'I .n’IrIIrIrl
`Ha! Iw Ilii- wh' rrih'rmr: an II'I‘II'I'II div nilm' al'a xma’i' m- m itl'sls'ri.~:irln.~ is Iran-II. .lua‘l
`llt'l'ulll‘ut' a
`alalihlii'al lt'fi'l ilvt'larta l lIl‘ I'tsulls “xignilii'anl,” iI llnwi mil Incan llIal [llL' LllllL'l't'llL 1w .1 I'I‘
`IIIl.‘LIIIIII§4llll. Wliy nnl'? Simply .~.I.IIL‘I|;
`0
`Sldllf’illt'lll hignilii'anu‘ 1'(‘l;IlL'\ In linw lilnrli' liit' nlIhL‘I'VL'il ('llt‘l'l is LllIL’ In L'Iiant‘l‘ Iil'.
`ramlnln c'rrnr tllll.’ In sampling} inslt‘ail III a “lrln'” llill't'rt'nu' lIL'l\\-‘L‘l‘ll ll'l'r‘ll nn‘m» nr
`ILII'lIllph. Ranilnni I'rt‘nr i» llIL' par] nl Iln' windy Illa! knililliii lIL‘ pl'crlii'lrrl, lt'. Illal part
`allrilinlalilr 1n t'llnillL'L'.
`
`0
`
`'
`
`'l‘llL'I'nlL‘nlIiiah'IL'g.u:JIl:iII11IlirIgianiliIHImII-nlialinmmlnnIlu‘I'véx'llllsrn't'dlnlu-
`mnxiclrrnli Ina pnnr-nualilyalnily,lIiasmayln'lln'primaryI'm-inn ll'lL‘l'L'Hllllhrll'L‘
`nr an‘ nnl “signilii'am” slaiixliullly. Bias may Irr'm'llnlc Iiniling a lruc i'l'li-L'I. This is
`a InIiiL' lHI' llllLII't' ur'IiLIL-x.
`ILliIiiLal \‘igtlilicam'v :‘L‘lalva In my IIIrrIIIIII'IIIJL’ {Ifllh‘ i‘lFM‘f‘l'L'Il I'lli‘r‘l aIIIl wlIL'Iln'r Ilw
`magni: lllll' nl' "L'III-I'l sin" is hip. I‘nnngh In L'nIH‘IIlIfI‘ ['lIIIIIgL'H In L'liIIiIal L'alL'.
`
`Tn L'xpanll nn IlIl‘u lasl pninl: An ansnyialinn Illal iw slaiixlically .‘ilgilllit'nilll may Ilnl luv
`lrinlngix'ally nr i'liniL'ally ngillllkfll‘ll.
`linr t‘XiIllHlli',
`il lln' Ilil'l'vrctlu' in lalnml [art-awry
`III nm' gl‘nlm nl' paliunls was slaIiI-elically Hignilii'anl Inn Ilic Llill'vrt-ni'v in lL'l'III‘i nl rI-al
`IIIIIIIllL'I‘}. wag I
`III!!! ”3; lllit'H i1 l‘l.’III'L‘.‘\'I.'IIl a hinlngii‘ally Inr L'linit'allyl fiignilit'anl tlilll'l"
`i'nu- given llIL’ limiiatinnh aIIIl \-'aria|1i|ily lllllt'l't'lll lrlnml |Ift‘hhlll'l‘ Iluu'rmiIIaIinn.‘ Nu.
`Illi'rt'afiingly, I't'\-'ikur-+ and “nu”: ma ken a rc lnnliing lit-ynnd alalialit'al hlgllllltdlltl’ lnl'
`Wirlurn't' til .1 “minimal clinically impm'lanl IlillL‘I'I'Iu v" Inr L'nmlnnnly llht‘ll nIIIt‘nnnw
`iiiraanI'L-w (cg. pain, Illi.‘ (ix-wmlry Llisaliilily llltlL'X}. I-aclnrim‘I l'lllliL'dl filglllllt'dlll'l‘ iIIln
`51ml)! Ilmign and pnwcr t'dlt'lllfllltlllfi aml I'L'Ilnrling r‘vx‘nlIx in Ivrmr. nl' (linii'al at. Will
`as Rin‘lll‘llll'fll wignilli'ancv will ht‘l'lll'lIL' im'ruasingly impnrlam lnr L‘valualing L‘lIiL'at'y.
`
`Summary
`Slalixlit'a! lL'hlh lIt'i|‘I (lihlillglllfill Irnr (llllL‘l't‘llL'L'h Iasmuialinnxi IrnIII LIIaIII'L' .iml I'L'h'llll
`ill .I
`I“ valin' \‘Vl'lll'll
`ii. an calimalinn nl prnlialiiliiy IlIaI llw rcwnlis‘ an: tlllt' In {hang-c. An
`arllill'al'y iL'N'l Ilirculinlll valuv {v}; usually alpha 2 .053 in mud [n Ilieilingnik‘h I'v-inlu llI.'I| ari-
`JNHIIIIICII In lw Illlt‘ In (lianu‘ Irnm Iln‘ I'I’Hllllh that a l't’ lllll.‘ In nilivr lat-Inn. 'I‘Inr linllnm liln':
`"
`H 1"" I'l'lealrilin IlICIl ihv I'L'Hllllh arc llllL' In rhanu' ix lt'fi'h Ilian I|1I~ IIII'L-s'linlii \"llllt'
`If”? .05}, ii
`ia llNHllillt'tl llH‘ Ilil'lvn'm'cs aI'L' tlllt‘ In Iln-w nlln'r I'ai'lnra m1. Irnc Ilillr‘r-
`L'nL'L‘H in II't'dllllt'lIl i'I'IL'L'Ia). llHl-VCVL‘I'. Wl‘ may in: wrnnii '3‘Ei. nl illL' Iinn‘.
`' Signilirani'r “Will”: in ilwll'ilnt's nnl Ialw inln au'nnnl lJL'HII'H' whirh may him. .511an
`I'r-wnlls. 'l‘hi: pimililr' Irxu‘plinn In llIlH is lIIlllll\-".1I‘ldll.‘ analyaix. H’lllt ll
`la a whim I lnr
`lnlnrv dl‘lit'li'h.
`
`-
`
`'
`
`.‘aanmlr sin.- aml randnn'l variatinn play an imlmrlanl rnl
`Hll‘lilkllt'dll'g' Hignilit‘ani nr nnl anil, lngcllirr Willi L'xln‘rlul I'l'l'ml ai-nz
`“lull?" 15" ”IHII-VI‘I'I‘II" In IIL'IL'L'I fililll‘illhll tllllt'l't'lltl’fi.
`A \‘ldllfillt'nllly Higniliranl I'l'HIlll dnvsna: “prnw” anylhinganrl .I’.
`1'vlaiinln'llip lac-Iwcvn llIL‘ I-xpnsm'v and lilliL'IIIIII'. 'l'liv linilingnl' an ‘
`nn'an Iliat lliL' awncialinn in i'allsal in numr lllh'lJIILL'N'. This is a IIII'IlL' lur lnlnrc Ill‘llt'lt'k.
`' Allhnngh a I‘mnll may Irv sIaIiHlii'alli! aigllllit'anl, lln' L'llt't'l sirl- [l(', nIaiIIIiIlIIlI' nl IlIt‘
`I-Ilun may nm l‘IL' Iainlngitally nr Limit-alli- Inmnrianl. In l'l'llll|lll|l'_l..‘., designing. ainl
`I'l'pnl'ling minim. llIL' minimal LliniL'ally imliananl Ilillcl'rnt'v ix inIIJnI'IanI In lilllhlllt'l.
`
`v in i-vhctln'r a run“ it.
`whi'llnrr IlII’
`
`m nu: mlulllinli .: I. amal
`'awni'irll ini I" l.ll‘l.“u Ilni
`
`IIHCH.
`Whilt' Slalislical lL"\'lilI§,’ ix an impnrlanl |IarI nl I'L’Nt'dl'l'll analI-wih, ilk lilnilalinnx.
`aml Illl'ill‘it'fi Ilt‘t‘ll 1n ln‘ mnsiilt'rul in nI‘IlL'r In iml I‘L’Iiilli‘i I)! a randy in Ilu' lll'lljll'l' L'nnlvxr
`lnlln'm'w iwIIL‘,i«*L’I.IL‘|x|L‘1|IvInpiinlL'nnlnnmiing,aliimpnl'lanlmulll'u‘nl|HI|I’IiIi.i|
`lIIaN wllii'll numla In lw L'nnsiilcrvil in all hlntlii'a I'vgal‘rllcwa nl Ilt'sign.
`
`i
`
`'._|'I|‘I'|Ilf'
`
`lir|'-.I'I1LILJIIII‘ {
`
`.m- FtIIIIII-Ill
`
`This material wasrupied
`at the NLM and may be
`Subject US Copyright Laws
`
`—.—__
`
`Vllllllllt.’ .EI' lHNIIL’ “l -— lllll
`
`