Analysis of Risk Factors for Spinal Pain: A Case Control Study of New Graduate Aviators Based on Imaging and Questionnaire Results.

Background: Disc degenerative diseases are common in occupational aviators exposed to long flight time and vibration during flight. The incidence of pathological and degenerative changes of spine in experienced pilots are widely studied and reported. However, few literatures focused on new graduate aviators. In this study we intended to describe imaging features of spine in new graduate aviators from flight academy and analyzed the risk factors for spinal pain.Methods: This is a retrospective study of 178 new graduate aviators. All received full-length lateral X-ray of spine and 1.5T magnetic resonance imaging (MRI) of cervical and lumbar spine. Sagittal alignments were measured through X-ray imaging. The degenerative grade of disc was defined according to Miyazaki and Pfirrmann grading classifications. The prevalence of degenerative disc diseases was reported under disc nomenclatures. The incidence of spinal pain during the last 12 months of flight training was acquired from questionnaires. Multivariate logistic regression analysis was utilized to analyses risk factors for spinal pain.Results: The whole cohort presented at least one level disc degeneration of Grade 2 in cervical or lumbar spine. 134 of 178 subjects (75.3%) showed at least one cervical disc degeneration in grade 3. 61 (34.3%) presented cervical disc bulging and 5 (3%) presented cervical disc protrusion. 110 (61.8%) aviators reported neck pain during the last 12 months. 53 of 178 (29.8%) volunteers had at least one lumbar disc degeneration in grade 3. 31 (17.4%) aviators presented lumbar disc bulging and 21 (11.8%) presented lumbar disc protrusion. 45 (25.3%) aviators reported back pain during the last 12 months. Multivariate logistic regression analysis showed age, cervical disc degeneration and bulging were risk factors for neck pain; lumbar disc degeneration, bulging and protrusion were risk factors for back pain. Conclusions: Moderate degrees of disc degenerative changes and diseases of spine could be found in new graduate aviators at an early age. Disc degeneration and diseases correlate strongly with spinal pain. It is essential to recognize these pathological conditions to intervene in the occurrence and development of degenerative changes in aviators in advance.