Abstract: Objective To provide the evidence for the diagnosis,treatment and medical identification of cervical and lumbar disorders in pilots and in those flying a modified aircraft by comparing their characteristics during annual physical examination. Methods A total of 12 809 pilots with a history of cervical and lumbar disorders underwent X-ray examination during their annual physical examination and 978 pilots flying a modified aircraft underwent X-ray examination and spiral CT scanning of L4 and L5 during annual physical examination.The detection rates of cervical and lumbar disorder,lumbar vertebral arch fissure,and other lumbar disorders were compared. Results The detection rate of cervical and lumbar disease,lumbar vertebral arch fissure and other lumbar disorders was significantly lower in pilots during annual physical examination than in those flying a modified aircraft during physical examination（3.7% vs 28.3%,χ²=1 063.53;0.2% vs 6.9%,χ²=576.63;2.3% and 1.2% vs 5.2% and 16.3%,χ²=30.97 and 939.95;P＜0.01）.The temporarily grounded rate was significantly lower in pilots due to cervical and lumbar disorder found in annual physical examination than in those flying a modified aircraft due to cervical and lumbar disorder found in physical examination（0.3% vs 2.4%,χ²=91.06,P＜0.01）.However,no significant difference was found in temporarily grounded rate of pilots and those flying a modified aircraft due to cervical and lumbar disorder detected in annual physical examination（χ²=0.001,P＞0.05）. Conclusion Radiography shows a high abnormal rate of cervical and lumbar vertebrae,but the diagnosis of cervical and lumbar disease cannot be established according to it.The diagnosis of cervical and lumbar disease can be established according to its history,annual physical examination and selective X-ray examination.However,its diagnosis can be made in those flying a modified aircraft according to the X-ray examination and spiral CT scanning of L4 and L5 findings.