Cervical disk bulges in fighter pilots.

This paper reports three cases of bulging cervical disks among fighter pilots flying high-performance aircraft who experienced acute in-flight neck pain during aerial combat maneuvers under high +Gz forces. Radiographic investigations (magnetic resonance imaging/computed tomography/myelography) revealed that disk bulges were the cause of the pain. One pilot underwent decompressive surgery, and two were treated conservatively. Acute in-flight neck pain and related problems, such as bulging cervical disks, may become more common, since the modern fighter aircraft of the future will be better able to create and sustain high +Gz forces than the fighter aircraft in use today. Further, the increasing number of helmet-mounted devices will make flight helmets heavier, thus placing increased stress on cervical structures.