Page 46 - JSOM Fall 2024

The Effect of Radiological Assessment
of Volunteers for French Paratrooper Training

A Five-Year Retrospective Study

Romain Montagnon, MD *; Louis Rouffilange, MD ; Géraldine Wagnon, MD ;
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Kévin Balasoupramanien, MD ; Gaëtan Texier, MD ; Luc Aigle, MD 6
ABSTRACT
Introduction: A systematic radiological examination is needed are needed to determine whether the candidate can serve in the
for military airborne troops in order to detect subclinical med- army as a paratrooper. Specific standards required of army per-
ical contraindications for airborne training. Many potential sonnel are described in ministerial instruction (MI) 812 and
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recruits are excluded because of scoliosis, kyphosis, or spondy- for paratroopers in MI 700. The medical fitness evaluation
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lolisthesis. This study aimed to determine whether complemen- allows candidates to enter airborne training at the French Air-
tary radiological assessment excludes too many recruits and borne School in Pau, France, and complete the six static-line
whether medical standards might be lowered without increas- jumps required to earn the airborne wings badge (Figure 1).
ing medical risk to appointees. Methods: This retrospective,
epidemiological, cross-sectional single-center study spanned FIGURE 1 Enlisted personnel completing airborne training
5 years at the French paratroopers’ initial training center. We (6 static-line jumps) at the French Airborne School in Pau, France.
analyzed all medical files and full-spine X-ray results of all en-
listed 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 full-
spine 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 Per MI 700, a systematic radiological examination is needed
5 years. Conclusion: The findings, supported by a literature for potential military airborne troops in order to determine
review of foreign military data, suggest that spondylolisthesis whether there is a subclinical medical contraindication to air-
above grade I and low back pain are more significant than sco- borne training. Our study will focus on this radiological ex-
liosis and kyphosis for establishing airborne standards. amination of the spine (anterior-posterior standing full-spine
X-ray and lateral cervical, thoracic, and lumbar spine X-ray).
Keywords: military medicine; airborne training; scoliosis; French medical standards of medical fitness for airborne troops
kyphosis; spondylolisthesis (MI 700) describe all disqualifying medical conditions on ini-
tial assessment, including current or history of severe traumatic
injury, chronic back pain, deviation or curvature of the spine as
scoliosis greater than 15°, dorsal kyphosis greater than 50°, or
Introduction
congenital or acquired spondylolisthesis at grades II and II. 14
French paratroopers’ deployment during airborne operations
show a high risk of injury during operational and training French medical fitness standards are among the toughest in the
jumps. Strict medical selection is needed to reduce this risk. world, while enlistment is increasing. The aim of this study is
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to determine whether complementary radiological assessment
In order to serve as a paratrooper in the French Army, two med- is excluding too many recruits, and whether medical standards
ical assessments are required: an initial assessment before en- might be lowered without increasing short- or long-term med-
listment and an entrance evaluation. These medical assessments ical risk to appointees.
*Correspondence to r.montagnon@yahoo.fr
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1 OF-2 Romain Montagnon is affiliated with the 11th Armed Forces Medical Center, 171st Medical Unit, Caylus, France. OF-2 Louis Rouffilange
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is affiliated with the 11th Armed Forces Medical Center, 167th Medical Unit, Carcassonne, France. OF-2 Géraldine Wagnon is affiliated with the
11th Armed Forces Medical Center, 171st Medical Unit, Caylus, France. OF-2 Kévin Balasoupramanien is affiliated with the 11th Armed Forces
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Medical Center, 173rd Medical Unit, Toulouse, France. OF-5 Gaëtan Texier is affiliated with the French Armed Forces Centre for Epidemiology
and Public Health (CESPA), Marseille, France. OF-6 Luc Aigle is affiliated with the French Military Health Service Academy, Bron, France.
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