title: Thoracic kyphosis and the prevalence of advanced uterine prolapse.
abstract: OBJECTIVE
  To determine if there is an association between the degree of thoracic kyphosis and the prevalence of advanced uterine prolapse in women.
  
  
  METHODS
  A retrospective case-control study compared the degree of thoracic kyphosis among white women with advanced uterine prolapse with that of matched controls. Medical records were reviewed for 412 consecutive women who underwent either abdominal or vaginal hysterectomy. The cases were those with uterine prolapse to or beyond the level of the introitus, and women with no evidence of prolapse served as controls. Spinal curvature was measured preoperatively for each patient using a lateral chest x-ray and the Ferguson method. Forty-eight cases were matched to 48 controls for age, weight, menopausal status, and hormonal status. Results were stratified to analyze the effect of parity on the relationship between uterine prolapse and thoracic kyphosis.
  
  
  RESULTS
  The degree of thoracic kyphosis was higher in patients with uterine prolapse than in controls (mean paired difference = 4.9 degrees, 95% confidence interval [CI] 3.1-6.7; P < .001). Patients with uterine prolapse had a mean spinal curvature of 13.0 degrees (95% CI 11.5-14.5), whereas controls had one of 8.1 degrees (95% CI 6.9-9.4). A higher degree of thoracic kyphosis was associated with an incremental higher occurrence of uterine prolapse (odds ratio 1.35, 95% CI 1.11-1.65; P < .01).
  
  
  CONCLUSIONS
  Thoracic kyphosis appears to be associated with uterine prolapse.
authors.affiliation: Department of Obstetrics and Gynecology, North Shore University Hospital-Cornell University Medical Center, Manhasset, New York, USA.
authors.forename: L R
authors.initials: LR
authors.lastname: Lind
authors.forename: V
authors.initials: V
authors.lastname: Lucente
authors.forename: N
authors.initials: N
authors.lastname: Kohn
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000150:complications* / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D013904:Thoracic Vertebrae; D014596:Uterine Prolapse / Q000150:complications*