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Table 7 Chinese Military Pilot Medical Waiver Guidelines for Lumbar Disc Herniation (LDH) and Lumbar Isthmic Spondylolisthesis (LIS) [26, 27]

From: Return to flight duty (RTFD) after posterior lumbar spine surgery for symptomatic lumbar disc herniation (LDH) and lumbar isthmic spondylolisthesis (LIS) in Chinese military pilots

Disease

LDH

LIS

Last update

April 2022

June 2021

Ground observation period

1 month after conservative treatment

3 months after open or minimally invasive isolated decompression

Spinal fusion surgery requires evidence of bony fusion and confirmation of stability on dynamic (flexion-extension) radiographs

3 months after conservative treatment

Spinal fusion surgery requires evidence of bony fusion and confirmation of stability on dynamic (flexion-extension) radiographs

Waiver consideration

Asymptomatic LDH or LDH symptoms resolved

No residual motor/sensory/reflex deficits

No lumbar motion restriction

Pass physical fitness tests without precipitating the disease

Pass rehabilitation assessments

Clearance by a spine surgeon to return to flight

Asymptomatic spondylolysis or asymptomatic grade I spondylolisthesis with no or mild spinal stenosis or LIS symptoms resolved

No residual motor/sensory/reflex deficits

No lumbar motion restriction

Pass physical fitness tests without precipitating the disease

Pass rehabilitation assessments

Clearance by a spine surgeon to return to flight

Additional remark

High-performance aircraft pilots must meet specific physical standards and acceleration endurance requirements without inducing symptoms and signs

Fighter and attack helicopter pilots with only residual mild symptoms after treatment that do not interfere with daily life and groundwork may be granted flight waivers for dual-control aircraft