Scoliosis (and waiver) info

[Guest Bushmaster]

Dear Flight Doc,

I just came from the chiropractor with a diagnosis of slight Scoliosis. The curvature is not really visible but you need to be a professional to see it. The doctor saw it from the front view X-Ray, and also added side view X-Ray is good, the spine looks in good shape...

I haven't been flying for 3 years (in civilian of course) and I know that your back is a big deal when flying fighters. The doctor said he will be able to straighten it with exercises and some therapy. But I am wondering, if one day I go thru UPT medicals, should I mention about this at all? I am sure they are checking this...

I would appreciate your comments on the situation.

Thank You!

John

[Murph]

To hold you off until FlightDoc can weigh in, AFI 48-123 mentions that anything beyond 30 degrees curvature lumbar and 20 degrees curvature thorassic is disqualifying using the COBB method. My memory is fuzzy, but the COBB method compares the vert where the curvature begins to where it ends to come up with the degree of deviation (try doing a google search).

[Guest Bushmaster]

Thanks Mike,

I heard that everyone has scoliosis to a slight degree, is that right?

[Guest Flight Doc]

The standards are the same no matter what airframe type.

A7.26.1.1.4. Lumbar scoliosis of more than 20 degrees or thoracic scoliosis of more than 25 degrees as measured by the Cobb method

A7.26.1.1.5. Abnormal curvature of the spine of any degree in which there is a noticeable deformity when the examinee is dressed, in which pain or interference with function is present, or which is progressive.

[Guest Bushmaster]

I was told mine was 3 to 4 degrees thoracic scoliosis, is there anyway to get this completely straightened? Or can it get worse? What precautions should I take?

There is no abnormal curvature of the spine which there is a noticeable deformity when I am dressed though, it is not noticeable at all...

[Guest Flight Doc]

There is no reasonable way to straighten it, there's no need to (it's essentially normal), and at your age, there's little likelihood of it changing.

[Guest steeda30]

Is this waiverable? I understand that maximum allowed angle of curvature is 20* in the lower lumbar area. Mine is a ~25*. I don't have any pain or back problems caused by it. Should I forget about flying fighters?

Thanks in advance.

[Guest F16PilotMD]

It's worth a shot at a waiver. I have no experience with this but...

I would proceed by getting an orthopaedic surgeon to evaluate and quantify the curavature. If it's less than 20, your good to go. If you've already done this and it's between 20 and 30, you MIGHT get a waiver approved for non-ejection seat aircraft. The problem is, there is no such category for initial applicants...you are either flying class I or you're not. Non-ejection seat restrictions come for those who are already past the initial physical...they are designated FCIIB. The B meaning, non-ejection seat.

WAIVER GUIDE:

CONDITION: ABNORMAL SPINAL CURVATURE

I. Overview. The center of gravity of the upper torso lies in front of the spine. Whenever loads are applied along the spinal axis, as in ejection, a torque is produced which increases as the disparity between the long axis of the spine and the line of application of the force is increased. While a Class IIB waiver may be granted to aircrew who are already trained, there is little point in considering for a waiver those who desire initial training involving ejection seat aircraft. The long term outcome in cases of scoliosis up to 30° is very favorable but above 30° is uncertain. Note that there is a 3-5° error in measurements taken by the Cobb method. Waiver is not necessary for cases of scoliosis of less than 25°. A waiver may be considered for individuals with scoliosis from 25-30°. Waiver is not normally granted when there is any noticeable deformity when the patient is dressed, when there is pain or interference with function or when the condition is progressive.

II. Aeromedical Concerns. Excessive kyphosis, scoliosis, lordosis or combinations of them may make the spine unstable during ejection and more prone to injuries. Symptomatic conditions may cause distracting backache during flight. Surgical treatment is disqualifying.

III. Information Required for Waiver Submission. Orthopedic consultation with measurement of any scoliosis by the Cobb method. Cardiology consultation may be required to exclude pulmonary hypertension in those cases where right axis deviation leads to ECG abnormalities.

IV. Waiver Considerations. Approximately 80% of applicants with the condition have been found qualified. Those who had completed training usually received Flying Class IIB waivers.

[Guest dudley]

I had corrective scoliosis surgery 5 years ago. I have rods in my back, but I am still just as mobil as before the surgery. The rods don't hinder me in any way. Can I get a waiver for this? Thanks for any responses.

[Guest F16PilotMD]

Tough to do. Any retained hardware is disqualifying. Especially tough is anything having to do with your spine because of ejection seats, etc. It is possible to get approved to only fly non-ejection seat aircraft, but that's typically only for pilots who are already "in" and get injured. If you are AD, I think you will have an uphill battle. If you are ANG or AFRES, and you have a flight doc who will apply the personal touch and hard work to your case, you may have a chance.

[Guest steeda30]

Have not taken the AFOQT/BAT, but I plan to take it next year. I have my private license with ~200 hrs and a so-so GPA (2.6). The really bad news is that I have scoliosis in the lumbar, it is ~35*. The surgeon/doctor that I have been seeing every 6 months says that in my case there is absolutely no reason that my spine is any less able to withstand an ejection or high G loading, than a normal spin.

I was wondering if I have any chance at getting a waiver for this, if I have excellent AFOQT/BAT scores and bring up the GPA, as well as letters of reccomendation, and perhaps a letter from the surgeon documenting my case. Would prefer a fighter slot, but any slot will do.

Thanks

- Rick C.

[Guest doctidy]

You are going to need a waiver just to come on active duty for 35 degrees. Lumbar scoliosis of over 20 degrees requires a waiver.

As for flying...I have not seen INITIAL flying waivers above 30 degrees. I have seen INITIAL waivers from 25 to 30 degrees.

I would agree w/ your spine doc that there is good safety data up to 30 degrees. Above 30 degrees there is limited aviation data.

[Guest nickr]

Looking for some clarification;

I have 30 degree thoracic scoliosis, and if I were to get a waiver for this, it would only approve for non-ejection seat aircraft. So, since the T-6 is an ejection seat aircraft you cannot do pilot training with a waiver for scoliosis. So, with thoracic scoliosis over 25 degrees, essentially you cannot fly unless you already went through UPT and then got the waiver. Is this correct?

[Guest GringoBoy87]

I have the AF Waiver guide PDF dated 20 December 2007. Is this the most recent one? And if it isn't where can I get the new one. I ask here because I myself have lumbar scoliosis (23 degrees as of measurements from October 2002) and am trying to get information.

Also where does this information below come from? Is there a document that I can download?

The standards are the same no matter what airframe type.

A7.26.1.1.4. Lumbar scoliosis of more than 20 degrees or thoracic scoliosis of more than 25 degrees as measured by the Cobb method

A7.26.1.1.5. Abnormal curvature of the spine of any degree in which there is a noticeable deformity when the examinee is dressed, in which pain or interference with function is present, or which is progressive.

Thanks in advance.