University of Oulu

Keskimölö T, Pernu J, Karppinen J, et alDegenerative cervical spine changes among early career fighter pilots: a 5-year follow-up. BMJ Mil Health 2023;169:291-296.

Degenerative cervical spine changes among early career fighter pilots : a 5-year follow-up

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Author: Keskimölö, Tuomas1; Pernu, J.1; Karppinen, J.2,3;
Organizations: 1Faculty of Medicine, University of Oulu, Oulu, Finland
2Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
3Finnish Institute of Occupational Health Oulu Regional Office, Oulu, Finland
4Air Force Command Finland, Tikkakoski, Finland
5Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
6Aeromedical Centre, Centre for Military Medicine, Finnish Defence Forces, Helsinki, Uusimaa, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
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Language: English
Published: BMJ, 2023
Publish Date: 2023-06-28


Introduction: Degenerative changes of the cervical spine often cause disability and flight duty limitations among Finnish Air Force (FINAF) fighter pilots. We aimed to study the effect of +Gz exposure on degenerative changes in the cervical spine by comparing cervical MRIs of FINAF fighter pilots and controls.

Methods: At baseline, the volunteer study population consisted of 56 20-year-old FINAF male fighter pilots (exposure group) and 56 21-year-old Army and Navy cadets (control group). Both groups underwent MRI of the cervical spine at the baseline and after 5 years. Degenerative changes evaluated using MRI included intervertebral disc (IVD) degeneration (Pfirrmann classification), disc herniations, uncovertebral arthrosis, Schmorl’s nodes, Modic changes, spinal canal stenosis, kyphosis and scoliosis.

Results: The degree of IVD degeneration in the whole cervical spine increased significantly in both populations with no between-group differences. The prevalence of disc herniations also tended to increase in both populations with no difference in the incidence over the follow-up. However, pilots proved to have more disc herniations at the baseline and at the follow-up. There were virtually no between-group differences in other assessed degenerative changes.

Discussion: We found that IVD degeneration and the prevalence of disc herniations increased at a similar rate for fighter pilots and non-flying military students when all cervical levels were summed up. The lack of difference may be explained by the relatively low cumulative +Gz exposure during the first 5 years of a pilots’ career.

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Series: BMJ military health
ISSN: 2633-3767
ISSN-E: 2633-3775
ISSN-L: 2633-3767
Volume: 169
Issue: 4
Pages: 291 - 296
DOI: 10.1136/bmjmilitary-2021-001848
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: This study was financially supported by a research grant from the Centre for Military Medicine, Finnish Defence Forces, Finland.
Copyright information: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.