Initial Head-Neck Posture Affects Neck Injury Risk in Pilot Emergency Ejection.

INTRODUCTION Neck injuries are commonly sustained during emergency aircraft ejections, with head-neck posture identified as a critical factor influencing injury risk. Despite this, the relationship between the initial head-neck posture and neck injury during emergency ejection has not been comprehensively studied. The objective of the present study was to investigate the effects of head-neck postures on the dynamic neck response of pilots during ejection. METHODS Using the Total Human Model for Safety, simulations were conducted involving four initial postures (i.e., rotation, flexion, extension, and lateral bending), each set at 15°, and four initial rotation angles (0°, 15°, 30°, 45°). Ejection acceleration curves were also simulated to the T1 vertebra and its inferior segments. RESULTS Neutral posture poses no risk of injury. In all the non-neutral postures (15°), only the rotation of 15° may cause risk of neck injury, and notably, this risk increases as the rotational angle increases. DISCUSSION Initial head-neck posture markedly influences cervical loading and injury risk during ejection. Axial rotation presents the greatest risk by elevating vertebral stress and ligament tension, emphasizing the critical importance of maintaining a neutral posture to protect the cervical spine during pilot ejection. Du C-F, Zhang X-Y, Zhao H, Liu S-Y, Li T-C, Wang X-W, Zhou K-T. Initial head-neck posture affects neck injury risk in pilot emergency ejection. Aerosp Med Hum Perform. 2026; 97(3):145-150.