title: Centrifuge-induced neck and back pain in F-16 pilots: a report of four cases.
abstract: BACKGROUND
  Early in their careers, as an important part of their training to become fighter pilots, pilots undergo centrifuge training in order to learn effective anti-G straining maneuvers (AGSM) and to test their G tolerance. The exposure of pilots, especially early in their careers, to training that could lead to injuries should be avoided. This is a report of four cases of neck pain experienced during G-tolerance training, some of which may have caused ongoing problems for the pilot.
  
  
  METHODS
  Four cases, describing four different injuries experienced during G-tolerance training, are presented, including the history of the incident, radiographic description, and physical examination.
  
  
  CONCLUSIONS
  Three main questions were identified in regards to the training of fighter pilots in centrifuges: 1) should the seat be positioned to imitate a specific aircraft's seat? 2) should the pilot wear a helmet and a mask? 3) what is the appropriate amount of head support? Based on the four cases reported it is recommended that pilots should be given the best possible conditions concerning neck support and load on the neck and the back for G-tolerance testing. Training the pilot in an anatomical neutral sitting position, without a helmet, and with maximal neck support minimizes head movements in cases of conscious or unconscious loss of muscle control. To test the stability of the neck in a setup similar to the environment where the pilot is going to operate, the pilot should be given the opportunity to prepare himself or herself accordingly in advance.
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Odense University Hospital, Odense, Denmark. brittlange@dadlnet.dk
authors.forename: Britt
authors.initials: B
authors.lastname: Lange
authors.forename: René Tyranski
authors.initials: RT
authors.lastname: Nielsen
authors.forename: Pernille Bro
authors.initials: PB
authors.lastname: Skejø
authors.forename: Palle
authors.initials: P
authors.lastname: Toft
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D019567:Back Injuries / Q000209:etiology; D001416:Back Pain / Q000209:etiology*; D002498:Centrifugation / Q000009:adverse effects; D006260:Head Protective Devices; D006801:Humans; D008297:Male; D008889:Military Personnel; D019838:Neck Injuries / Q000209:etiology; D019547:Neck Pain / Q000209:etiology*; D014911:Whiplash Injuries / Q000209:etiology*; D055815:Young Adult