Introduction: Although it is known that some degenerative changes occur in the spines of fighter pilots, it is not clear whether their frequent exposure to high acceleration is associated with premature development of such changes. This case-control study was designed help answer that question.
Methods: There were 12 Finnish Air Force pilot cadets and their controls who were examined using cervical and lumbar magnetic resonance imaging (MRI) before the pilots started fighter training (baseline) and 13 yr later (follow-up) when the pilots had accumulated a total of 1200 +/- 470 h in fighter aircraft.
Results: No statistical differences were found between groups with respect to the frequency of degenerative changes in either the cervical or lumbar spine. Cervical changes in pilots were for the most part observed in the lower part of the neck, while controls showed more variability as to location. In the lumbar region, pilots showed a non-significant tendency toward more changes in disks L4-S1, including changes in signal intensity, height, protrusions, and end plates.
Conclusion: Occupational exposure to acceleration in fighter aircraft did not cause significant radiological changes in the spinal column during the first 13 yr of a fighter pilot's flying career. Assessments for the need of a fighter pilot's follow-up imaging should be based on clinical outcome, not on periodic imaging.