海军高性能战机飞行人员腰椎退行性病变危险因素分析

目的 探索海军高性能战斗机飞行员腰椎退行性病变的相关因素，研究针对性预防及治疗方案。 方法 利用问卷调查方式结合脊柱影像学资料对相关飞行员进行评价。调查问卷内容包括: 一般资料、生活方式、飞行训练方式等暴露因素；脊柱影像学检查项目包括：腰椎MRI和腰椎X线。将存在腰椎退行性病变的飞行员纳入退变组，无腰椎退变的飞行员纳入健康组，采用单因素方差分析和Logistic回归模型进行危险因素的筛选。 结果 参与研究的海军高性能战机飞行员腰椎退行性病变的整体患病率为45.8% (66/144)。5个相关的危险因素分别为久坐（OR=2.714）、缺乏腰背肌锻炼（OR=3.136）、飞行中静态姿势引起不适(OR=8.16)、飞行中腰椎矢状位不正(OR=8.397)、飞行中腰椎冠状位不正(OR=2.744)。 结论 海军高性能战斗机飞行员腰椎退行性病变发病率较高，飞行中持续的静态姿势不适和腰椎冠状位、矢状位失稳是腰椎退变的重要诱因，减少久坐、加强腰背肌锻炼也是避免腰椎退变的重要方法。

Risk factors analysis of lumbar degenerative diseases in high-performance fighter pilots of the Navy

Objective To investigate the relevant factors contributing to lumbar degenerative diseases among high-performance fighter pilots in the navy, and to develop treatment strategies. Methods The pilots were assessed using a questionnaire and spinal imaging data, which included lumbar MRI and X-ray scans. The questionnaire covered general information, lifestyle habits, flight training experiences, as well as other exposure-related factors. Pilots with lumbar degenerative disease were categorized into the degenerative group, while others were classified as part of the healthy group. The risk factors were screened using a one-way ANOVA and logistic regression model. Results Among Navy high performance fighter pilots, the overall prevalence of lumbar degenerative disease was 45.8% (66/144). Prolonged sitting (OR=2.714), lack of lumbar and back muscle exercise (OR=3.136), static postural discomfort during flight (OR=8.16), lumbar sagittal misalignment during flight (OR=8.397), and lumbar coronal misalignment during flight (OR=2.744) were identified as five associated risk factors. Conclusion The prevalence of lumbar degenerative diseases is high among Navy high-performance fighter pilots, primarily due to continuous static postural discomfort and lumbar coronal and disjointing position instability during flight. Reducing sedentary time and strengthening lumbar and back muscle exercise are crucial preventive measures against the development of such conditions.