MRI study of the morphometry of the cervical musculature in F-16 pilots

Introduction: In fighter pilots neck muscle strengthening exercises are often recommended to protect the neck against pathologies. The aim of the current study was to compare the relative cross-sectional area (rCSA) and muscle:fat ratio of the cervical musculature of F-16 pilots experiencing neck pain and no neck pain (control) pilots. In addition, correlations between these morphometric characteristics, cervical range of motion (CROM), and neck muscle strength were evaluated. Methods: There were 35 male F-16 pilots who volunteered, of which 10 experienced bilateral neck pain. A standardized questionnaire was used to collect personal information. Magnetic resonance imaging (MRI) was assessed at the C5-C6 level to determine rCSA and muscle:fat ratio. The CROM (Zebris) and the maximum isometric strength (David F140 device) were measured. Results: The rCSA of the semispinal is cervicis and multifidus was significantly larger in the neck pain group (left: 2.08 cm²; right: 1.81 cm²) on both the left and the right side, in comparison to the control population (left: 1.29 cm²; right: 1.26 cm ²). In the pain group, the rCSA of the semispinalis cervicis and multifidus was significant larger on the left than on the right side (left: 2.08 cm²; right: 1.81 cm²). No differences in the muscle:fat ratio between control pilots and pilots with neck pain could be determined. Between groups no differences were found in the CROM and the neck muscle strength. Discussion: It is hypothesized that the larger rCSA in the neck pain group compared to the control group might be caused by greater activity of the deep neck muscles in the neck pain group. The asymmetrical operation of the F-I 6 might cause the asymmetry within this group.