Introduction: A systematic radiological examination is needed for military airborne troops in order to detect subclinical medical contraindications for airborne training. Many potential recruits are excluded because of scoliosis, kyphosis, or spondylolisthesis. This study aimed to determine whether complementary radiological assessment excludes too many recruits and whether medical standards might be lowered without increasing medical risk to appointees.
Methods: This retrospective, epidemiological, cross-sectional single-center study spanned 5 years at the French paratroopers' initial training center. We analyzed all medical files and full-spine X-ray results of all enlisted troops during this period. Secondary evaluation by an orthopedic surgeon enabled 23 enlisted personnel, deemed medically unacceptable because of X-ray findings, to be given waivers for airborne training. A follow-up review of their 23 files was conducted to determine whether static-line parachute jumps were hazardous to those who were initially declared medically unacceptable.
Results: Of the 3,993 full-spine X-rays, 67.5% (2,695) were described as having normal alignment and structure; 21.8% (871) had lateral spinal deviation; and 10.7% (427) had scoliosis. Sixty-six recruits (1.6%) were deemed unfit because of findings that did not meet the standard on the fullspine X-ray: 53 enlisted personnel had scoliosis greater than 15°, and 13 had spondylolisthesis (grade II or III). Of the 23 patients granted waivers, 82.3% with scoliosis (14) and all patients with kyphosis had not declared any back pain after 5 years.
Conclusion: The findings, supported by a literature review of foreign military data, suggest that spondylolisthesis above grade I and low back pain are more significant than scoliosis and kyphosis for establishing airborne standards.
Keywords: airborne; kyphosis; military medicine; scoliosis; spondylolisthesis.
2024.