Keskimölö Tuomas, Oura Petteri, Honkanen Tuomas, Niinimäki Jaakko, Sovelius Roope, Leino Tuomo, Karppinen Jaro
Faculty of Medicine, University of Oulu, Oulu 90220, Finland.
Research and Development Section, Centre for Military Medicine, Finnish Defence Forces, Helsinki 00290, Finland.
Mil Med. 2025 Apr 23;190(5-6):e930-e937. doi: 10.1093/milmed/usae452.
Fighter pilots work in a unique environment and are subject to high G-force loads under simultaneous head movements. Neck pain is reported to be a common health problem among fighter pilots leading to time lost flying and flight duty limitations. The present study aimed to find out if differences in early military flight career G-force exposure levels could increase the risk for degenerative changes in the cervical spine.
The study population consisted of 56 20-year-old Finnish Air Force male fighter pilot cadets, who underwent MRI of the cervical spine at baseline and after 5 years. During follow-up, the G-force exposure was measured using the individual Fatigue Index (FI) recordings. The FI data were collected from each flight with BAE Hawks and is determined by the number of times certain levels of G-forces are exceeded during the flights. The incidence or progression of each degenerative change was compared to individual FI values using Pearson correlation coefficients.
The pilots flew on average 220 (±21) hours with high performance aircraft during follow-up, resulting in an average FI of 1.98 (±0.47). A statistically significant progression was found in intervertebral disc (IVD) degeneration sum score with no correlation to corresponding FI values. A statistically significant increase was also found in the prevalence of IVD herniations with a negative correlation with FI values. Other degenerative cervical spine changes did not progress or did not correlate with corresponding FI values.
The prevalence of IVD degeneration and IVD herniations increases in the early phases of fighter pilots' career. Only the incidence of IVD herniations correlated with FI values and the correlation was negative. The negative correlation may be attributed to avoidance behavior due to neck pain, which was not measured in our study, or other unmeasured confounding factors. This was the first study to compare individual G-force exposure levels to high-quality MRI data over a follow-up of several years. Finnish fighter pilots are known to report increasing cervical symptoms during the Hawk training phase, but longer follow-up periods are likely needed to determine the association between G-force exposure levels and cervical degenerative changes.
战斗机飞行员工作环境独特，在头部同时运动时会承受高过载。据报道，颈部疼痛是战斗机飞行员中常见的健康问题，会导致飞行时间损失和飞行任务受限。本研究旨在探究早期军事飞行生涯中过载暴露水平的差异是否会增加颈椎退行性变的风险。
研究对象为56名20岁的芬兰空军男性战斗机飞行学员，他们在基线时和5年后接受了颈椎MRI检查。在随访期间，使用个体疲劳指数（FI）记录来测量过载暴露情况。FI数据从每次使用BAE“鹰”式飞机的飞行中收集，由飞行期间超过特定过载水平的次数确定。使用Pearson相关系数将每种退行性变的发生率或进展与个体FI值进行比较。
在随访期间，飞行员平均驾驶高性能飞机飞行220（±21）小时，平均FI为1.98（±0.47）。发现椎间盘（IVD）退变总分有统计学意义的进展，与相应的FI值无相关性。IVD突出的患病率也有统计学意义的增加，与FI值呈负相关。其他颈椎退行性变未进展或与相应的FI值无相关性。
战斗机飞行员职业生涯早期IVD退变和IVD突出的患病率增加。只有IVD突出的发生率与FI值相关，且相关性为负。这种负相关可能归因于颈部疼痛导致的回避行为（本研究未测量）或其他未测量的混杂因素。这是第一项在数年随访期间将个体过载暴露水平与高质量MRI数据进行比较的研究。已知芬兰战斗机飞行员在“鹰”式训练阶段报告颈部症状增加，但可能需要更长的随访期来确定过载暴露水平与颈椎退行性变之间的关联。
