Spinal MRI in fighter pilots and controls: a 13-year longitudinal study

Area of Science:

• Aerospace Medicine
• Occupational Health
• Radiology

Background:

• Fighter pilot occupational exposure to high acceleration is known to cause some spinal degenerative changes.
• The association between frequent high acceleration and premature spinal degeneration in pilots remains unclear.

Purpose of the Study:

• To investigate if frequent exposure to high acceleration in fighter pilots is linked to premature development of spinal degenerative changes.
• To compare spinal health in fighter pilot cadets and controls over a 13-year period.

Main Methods:

• A case-control study involving 12 Finnish Air Force pilot cadets and matched controls.
• Cervical and lumbar spine magnetic resonance imaging (MRI) performed at baseline and after 13 years.
• Pilots accumulated an average of 1200 +/- 470 flight hours during the follow-up period.

Main Results:

• No statistically significant differences in the frequency of cervical or lumbar spine degenerative changes were observed between pilots and controls.
• Pilots showed a non-significant tendency towards more lumbar degenerative changes (L4-S1), including disc signal intensity, height, protrusions, and end plate changes.
• Cervical changes in pilots were predominantly in the lower neck, whereas controls exhibited more varied locations.

Conclusions:

• Occupational exposure to acceleration in fighter aircraft did not result in significant radiological spinal changes during the initial 13 years of a pilot's career.
• Follow-up imaging for fighter pilots should be guided by clinical outcomes rather than routine periodic assessments.
• This study suggests that current flight protocols may not significantly accelerate spinal degeneration in the first decade of a fighter pilot's career.