A rare case of acute myelopathy secondary to an occult type II odontoid fracture in a fighter pilot following high-G manoeuvres

Spinal injuries in pilots are well-recognised consequences of high G-forces and awkward head positions.1 While these stresses are typically related to degenerative changes, acute myelopathy secondary to an occult type II odontoid fracture is comparatively rare. Military pilots exhibit higher rates of cervical degeneration than controls due to cumulative flight forces, underscoring the need to consider occupational factors during evaluation.2 In contrast to the extreme axial loading of seat ejection, which can reach peak loads of 21 G with onset rates of 300 G/s,3 this case demonstrates that manoeuvring forces alone, even at lower G-levels, can induce spinal instability in the presence of an underlying occult lesion.