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The German and Belgian standards are interesting, as they re- Spondylolisthesis above grade I seems to worsen and become
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quire the use of a full-spine X-ray only if there are warning increasingly symptomatic as more jumps are made. In our
signs during the clinical examination. In this study, only 1.6% study, the only enlisted soldier with an anterior listhesis of
(66) of full-spine X-ray recipients were unfit for static jump grade 2 was requesting an invalidity pension for low back pain.
training. Since performing a full-spine X-ray is irradiating, is
it wise to perform this examination systematically? The intro- Conclusion
duction of systematic full-spine X-rays for military airborne
personnel is recent (MI 700 was published in 2008). Of the 3,993 candidates found to be medically acceptable
for service and who underwent full-spine X-rays, 97.5%
These studies and our study favor expanding spine X-ray med- (n=3,893) were fit for static-line jumps and 2.5% (n=100)
ical standards to include scoliosis with an angle of 20°, while were unfit. Sixty-six enlisted personnel (1.6%) were unfit be-
focusing medical selection on clinical examination. cause they were found to not meet the MI 700 standard on
full-spine X-ray: 53 had scoliosis greater than 15°, and 13
The Search for a New Threshold had spondylolisthesis (grades II or III). The data we gathered,
Of the 4,115 spine X-rays reviewed, 70 (1.7%) examples of supported by a literature review that included foreign armies,
scoliosis with an angle between 16° and 20° were described. shows that low back pain and spondylolisthesis above grade I
Of 16 enlisted personnel who were diagnosed with scoliosis of are more significant than scoliosis and kyphosis when consid-
between 16° and 21° and were medically accepted for airborne ering airborne standards.
duty, none reported low back pain or trauma following a para-
chute jump in 2016. Author Contributions
MR, WG, TG, and AL participated in the study conception
Those facts lead us to propose a new threshold for scoliosis, and design. MR and WG acquired the data, and MR, RL, WG,
with an angle of up to 20° (measured by the Cobb method), BK, TG, and AL analyzed it. MR, WG, and RL in drafted the
which is in line with U.S. Army standards. Medical unaccept- manuscript, and BK, TG, and AL revised it.
ability will remain for scoliosis with an angle above 20°, as
measured by the Cobb method. Disclosures
The authors have nothing to disclose.
Reproducibility and Quality of Radiological
Interpretation of Spine X-Rays Funding
Three enlisted personnel whose spine X-rays initially presented No funding was received for this work.
scoliosis with an angle above 20° repeated the procedure in a
civil clinic; the second X-rays measured an angle less than or References
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