$4.5M Grant from Department of Defense to Study Neck Injuries

I recently spotted an article highlighting Wake Forest University (North Carolina, represent!) receiving a $4.5 Million Grant from Department of Defense to Study Neck Injuries. So let’s delve into this further…

What to know

Grant and Funding: Researchers at Wake Forest University School of Medicine received a 3-year, $4.5 million grant from the Department of Defense.

Study Focus: The study will investigate cervical spine (neck) injuries in military personnel, especially those using head-supported mass, such as helmets and night vision equipment.

Impact of Injuries: These injuries can lead to lost-duty days, disability, and reduced military readiness.

High-Risk Groups: Special forces combat soldiers, who carry heavy equipment and engage in high-acceleration activities (e.g., parachute jumps), are particularly susceptible to neck injuries.

Research Goal: The study aims to analyze head-supported mass design features, identify risk factors, and develop ways to reduce injury and chronic neck pain.

Previous Research: The research is a continuation of work exploring cervical spine issues in special forces soldiers, conducted in collaboration with Wayne State University and Duke University.

Study Methods: The research team will:

• Conduct strength and range-of-motion testing.
• Use musculoskeletal imaging to track degenerative changes in soldiers at Fort Liberty.
• Analyze movement during common military tasks to identify injury mechanisms.

Biomechanical Modeling: Participants will be tested with and without head-supported mass to find ways to reduce cervical spine stress.

Broader Impact: The research could benefit civilian professionals, like law enforcement and firefighters, who also wear heavy head-supported equipment.

Outcome Goal: Develop interventions or guidelines, including physical training or equipment redesign, to prevent injuries, chronic pain, and disability.[1]

Why is this important?

“From 2000 to 2009, there were 4,048 cervical spine fractures in a population at risk of 13,813,333 servicemembers. The overall incidence of cervical spine fractures was 0.29 per 1,000 person-years, and the incidence of fracture associated SCI was 70 per 1,000,000.”[2]

“Neck pain is common in the military, with 1-year prevalence as high as 83% and lifetime prevalence as high as 78%. Old age (OR = 5.0), poor neck mobility (OR = 3.61), shoulder pain (OR = 4.9), low back pain (OR = 2.3), high-G pilots (OR = 1.6), longer flight time (OR = 2.53), type of aircraft (OR = 3.93), and use of helmets and night vision systems (OR = 1.9) may be associated with the prevalence of neck pain.”[3]

“Nowadays, spine-related disabling conditions correspond to a major cause of medical discharge from the military service (14%) among American combat-wounded soldiers.”[4]

According to the United States:

• Air Force, a service member with “Un-united fractures, history of instability of a major joint, certain retained orthopedic fixation devices, severe scoliosis, or any condition that could interfere with daily participation in rigorous physical training or athletic programs, wearing of military equipment, or detract from military bearing and appearance are disqualifying.”[5]
• Navy and Marine Corps, if a service member’s condition can affect flight safety, you are disqualified.[6]
• DOD INSTRUCTION 6130.03, VOLUME 1 | MEDICAL STANDARDS FOR MILITARY SERVICE: APPOINTMENT, ENLISTMENT, OR INDUCTION [7]
  • 6.9 NECK
    • c. Current contraction of the muscles of the neck, spastic or non-spastic, or cicatricial contracture of the neck to the extent that it may reasonably be expected to interfere with properly wearing a uniform or military equipment, or is so disfiguring as to reasonably be expected to interfere with or prevent satisfactorily performing military duty.
  • 6.16 SPINE AND SACROILIAC JOINT CONDITIONS
    • f. History of vertebral fractures including:
    • (1) Cervical spine fracture.

Cervical fractures are not only common in the U.S. military but can also end careers, which makes them particularly devastating. While other jobs might allow employees to continue working after such an injury, military personnel are often forced into early discharge. Society tends to focus on injuries sustained by professional athletes, leading to advancements in “sports medicine,” but this research shift towards protecting service members is crucial. By improving injury prevention and care for military personnel, we can preserve careers, enhance military readiness, and better support those who risk their lives for national security.

References

[1] Researchers at Wake Forest University School of Medicine Receive $4.5 Million Grant from Department of Defense to Study Neck Injuries. (2024, October 17). Atrium Health Wake Forest Baptist. https://newsroom.wakehealth.edu/news-releases/2024/10/wake-forest-university-school-of-medicine-receives-grant-from-department-of-defense

[2] Schoenfeld AJ, Sielski B, Rivera KP, Bader JO, Harris MB. Epidemiology of cervical spine fractures in the US military. Spine J. 2012 Sep;12(9):777-83. doi: 10.1016/j.spinee.2011.01.029. Epub 2011 Mar 9. PMID: 21393068.

[3] Tang, L., Zhang, Y., Du, S., & Wang, X. (2024). Prevalence and related factors for neck pain in military personnel: a systematic review. EFORT Open Reviews, 9(8), 806–816. https://doi.org/10.1530/eor-23-0150

[4] Rivera JC, Anderson ER, Jenne JW, Topp RF. Spine-related disability following combat injury. J Surg Orthop Adv. 2014;23:136–139. https://pubmed.ncbi.nlm.nih.gov/25153811/

[5] Disqualifications | Medical requirements | U.S. Air Force Academy. (2023, April 14). U.S. Air Force Academy. https://www.academyadmissions.com/requirements/medical/disqualifications/#:~:text=Un%2Dunited%20fractures%2C%20history%20of,from%20military%20bearing%20and%20appearance

[6] Richard W Lang, Adam J Yoder, Paul Porensky, Perspectives on Cervical Arthroplasty in Navy and Marine Corps Tactical Jet Aircrew, Military Medicine, Volume 187, Issue 7-8, July-August 2022, Pages 204–208, https://doi.org/10.1093/milmed/usac012

[7] Office of the Under Secretary of Defense for Personnel and Readiness, Wilkie, R. L., & Vazirani, A. S. (2018). DOD Instruction 6130.03, Volume 1: Medical Standards for Military Service: Appointment, enlistment, or induction. https://www.esd.whs.mil/DD/

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