Human and behavioral factors contributing to spine-based neurological cockpit injuries in pilots of high-performance aircraft: Recommendations for management and prevention

In high-performance aircraft, the need for total environmental awareness co upled with high-g loading (often with abrupt onset) creates a predilection for cervical spine injury while the pilot is performing routine movements w ithin the cockpit. In this study, the prevalence and severity of cervical s pine injury are assessed via a modified cross-sectional survey of pilots of multiple aircraft types (T-38 and F-14, F-16, and F/A-18 fighters), Ninety -five surveys were administered, with 58 full responses, Fifty percent of a ll pilots reported in-flight or immediate post-flight spine-based pain, and 90% of fighter pilots reported at least one event, most commonly (>90%) oc curring during high-g (>5 g) turns of the aircraft with the head deviated f rom the anatomical neutral position. Pre-flight stretching was not associat ed with a statistically significant reduction in neck pain episodes in this evaluation, whereas a regular weight training program in the F/A-18 group approached a significant reduction (mean = 2.492; p < 0.064), Different coc kpit ergonomics may vary the predisposition to cervical injury from airfram e to airframe. Several strategies for prevention are possible from both an aircraft design and a preventive medicine standpoint. Countermeasure strate gies against spine injury in pilots of high-performance aircraft require ad ditional research, so that future aircraft will not be limited by the human in control.