Table 7.

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

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