Abnormal Pattern of Spondylosis and Postflight Neck Flexibility in Fifth-Generation Fighter Pilots

Area of Science:

• Aerospace Medicine
• Orthopedics
• Biomechanics

Background:

• Cervical spine degeneration is a natural process exacerbated by daily loading, such as whole-body vibration.
• Military fighter pilots face extreme biomechanical stress, including high Gz forces, helmet mass, and non-neutral head-neck postures.
• This study aimed to characterize cervical spine degeneration in fighter pilots and its functional impact.

Purpose of the Study:

• To characterize the pattern and incidence of cervical spine degenerative changes in fifth-generation fighter pilots.
• To identify functional consequences of these degenerative changes on cervical spine range of motion (CROM).
• To explore potential mechanisms underlying the observed degenerative patterns and functional deficits.

Main Methods:

• Cervical spine MRI scans were performed on 18 fifth-generation fighter pilots.
• Degenerative changes (disc bulges, foraminal stenosis, uncovertebral hypertrophy) and their locations were documented.
• Cervical spine range of motion (CROM) was measured pre-flight and post-flight, and correlated with degenerative findings.

Main Results:

• All pilots showed significant degenerative changes, including multiple disc bulges, foraminal stenosis, and uncovertebral hypertrophy.
• Degenerative findings were not correlated with pre-flight CROM.
• A strong negative correlation was found between the incidence of degenerative findings and post-flight reductions in extension, lateral bending, and axial rotation CROM.

Conclusions:

• Fighter pilots display an abnormal pattern of cervical spine degeneration, distinct from civilians, with higher incidence and upper spine predilection.
• The correlation between degenerative findings and post-flight CROM deficits, but not pre-flight CROM, suggests a pain-mediated mechanism.
• These findings highlight the unique biomechanical challenges faced by fighter pilots and their impact on cervical spine health.