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  • Return to Active Duty Rates after Anterior Cervical Spine Surgery in Military Pilots

    Final Number:

    Charles A. Miller MD; John Jacob Delaney MD; Joseph Spinelli BS, MD; Daniel J. Coughlin MD; Jason H Boulter MD; Michael K. Rosner MD; Chris J. Neal MD; Michael S. Dirks MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2018 Annual Meeting

    Introduction: Cervical radiculopathy affects the general population and can be managed both surgically and medically. In the military, however, radiculopathy can be debilitating, restricting soldiers from career advancement if their pain limits their capabilities to function at the expected level. It is in the military's interest to understand the effect surgically treated radiculopathy has on the active duty soldier in regards to active duty status and unit medical readiness. We sought to determine the return to duty rates in active duty pilots after surgery for cervical radiculopathy.

    Methods: We performed a single-center retrospective analysis of active duty soldiers undergoing anterior cervical discectomy fusion (ACDF) or total disc replacement (TDR) for radiculopathy between January 1, 2010, and June 1, 2017. We reviewed all patients between that time period and identified only active duty soldiers. Pilots were identified based on their military occupational specialty code (MOS).

    Results: Between Jan 1, 2010 and Jun 1, 2017 we performed 453 ACDFs and 201 TDRs. We identified 25 active duty pilots who underwent an ACDF or TDR. There were 7 ACDFs and 18 TDRs. The average follow up period was 323 days. Pilots were cleared for unrestricted flight status at an average of 124 days from surgery. Patients either received a waiver for unrestricted flight status or were approved by their flight commander at an average of 254 days. There were only 2 pilots who received medical boards for not meeting physical requirements but unrelated to cervical spine pathology.

    Conclusions: The Army, Navy, and Air Force have their own standards for pilots but single level ACDF or TDR has been recommended as a waiverable condition. This is the first study to confirm that cervical radiculopathy is a waiverable condition and can be treated effectively with surgery without affecting a pilot’s ability to maintain an unrestricted flying status.

    Patient Care: Yes our results will help educate military commanders on the post operative expectations after surgery for cervical radiculopathy in active duty pilots. This will help with patient referral to neurosurgery and mitigate physician avoidance by pilots concerned about medical conditions affecting their career.

    Learning Objectives: By the conclusion of this session, participants should be able to understand the implications of cervical radiculopathy on active duty pilots and understand that this is a waiverable condition and should not restrict an active duty pilot's career.

    References: PMID: 27244077

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