Coakwell Mark R, Bloswick Donald S, Moser Royce
US Air Force School of Aerospace Medicine, Brooks AFB, TX, USA.
Aviat Space Environ Med. 2004 Jan;75(1):68-80.
Neck injuries are a significant concern for aviators of high performance aircraft. A recent comprehensive technical report on cervical spinal injury associated with exposure to sustained acceleration, from NATO's Research and Technology Organization, recommended delineating the neck muscles used by aviators in this flying environment and developing improved neck muscle strengthening programs in an attempt to reduce such injuries.
A review of current literature was conducted in the fields of biomechanics, ergonomics, orthopedics, neurology, neurosurgery, rehabilitative medicine, and aerospace medicine. An objective description is provided of the muscles involved in specific head and neck movements, and those movements that are associated with a greater risk of injury during high-G sorties. The intensity and duration of force exposures common to high performance aircraft sorties, the effects of seat-back angle on these exposures, and the types and mechanisms of neck injury reported in this environment are also described.
Primary, secondary, and tertiary preventive interventions are introduced with the goal of providing unit-level flight surgeons an approach to reducing neck injury and promoting prompt, safe return to flying of aviators with identified neck injury. A central component of these interventions is a "specific" and "intensive" neck muscle training regimen, as described in the medical literature.
Increased axial compressive force and unique biomechanics combine to make neck injury likely in high performance aviators. The application of some proposed intervention strategies may reduce the occurrence of these injuries.
颈部损伤是高性能飞机飞行员的重大担忧。北约研究与技术组织最近一份关于与持续加速度暴露相关的颈椎损伤的综合技术报告建议，明确飞行员在这种飞行环境中使用的颈部肌肉，并制定改进的颈部肌肉强化计划，以试图减少此类损伤。
对生物力学、人体工程学、骨科、神经学、神经外科、康复医学和航空航天医学领域的现有文献进行了综述。客观描述了特定头部和颈部运动中涉及的肌肉，以及在高过载飞行任务期间与更高损伤风险相关的那些运动。还描述了高性能飞机飞行任务中常见的力暴露强度和持续时间、座椅靠背角度对这些暴露的影响，以及在这种环境中报告的颈部损伤类型和机制。
引入了一级、二级和三级预防干预措施，目标是为部队级飞行外科医生提供一种方法，以减少颈部损伤，并促进已确诊颈部损伤的飞行员迅速、安全地恢复飞行。如医学文献中所述，这些干预措施的一个核心组成部分是“特定”且“强化”的颈部肌肉训练方案。
增加的轴向压缩力和独特的生物力学相结合，使得高性能飞行员颈部受伤的可能性增加。应用一些提议的干预策略可能会减少这些损伤的发生。
