title: Pelvic Floor Symptoms and Spinal Curvature in Women.
abstract: To characterize the association between thoracic (T) and lumbar (L) spinal curvature and pelvic floor (PF) symptoms (pelvic organ prolapse, urinary incontinence [UI], fecal incontinence [FI]).
  
  
  
  Of women undergoing a bone mineral density scan from January 2007 to October 2010, patients who completed PF symptom questionnaires and had T and/or L spine radiographs or computed tomography examinations within 3 years of questionnaire completion were included in this study. The spine angles were measured using the Cobb angle method. The T and L curvatures were categorized as hypokyphosis (<20°), normal T kyphosis (20-40°), hyperkyphosis (>40°), hypolordosis (<40°), normal L lordosis (40-70°), and hyperlordosis (>70°). The presence and type of UI were identified with the 3 Incontinence Questionnaire and FI with the Modified Manchester Questionnaire. Pelvic organ prolapse was defined as a positive response to the presence of a bulge question from the PF Distress Inventory-20.
  
  
  
  Of 1665 eligible women, 824 and 302 (mean age 64 ± 10 for both) had T and L spine images, respectively. No differences in PF symptoms were observed in the T or L spine groups categorized by hypo-, normal, and hyperkyphosis/lordosis except for urgency UI being more prevalent in the hypolordosis group (P = 0.01). However, upon further characterization using logistic regression, no association was noted between PF symptoms and T or L spine angles; no differences in the mean angles were found between women with versus without PF symptoms (P ≥ 0.05).
  
  
  
  The current study shows that the T and L spinal curvatures are not associated with the presence of PF symptoms.
authors.affiliation: From the *Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, †Department of Radiology, ‡Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL; §Center for Pelvic and Women's Health, Marathon Physical therapy and Sports Medicine, LLC, Norton, MA ∥Division of Clinical Immunology and Rheumatology, UABH Osteoporosis Prevention and Treatment Clinic, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Isuzu
authors.initials: I
authors.lastname: Meyer
authors.forename: Tatum A
authors.initials: TA
authors.lastname: McArthur
authors.forename: Ying
authors.initials: Y
authors.lastname: Tang
authors.forename: Jessica L
authors.initials: JL
authors.lastname: McKinney
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Morgan
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000209:etiology*; D011859:Radiography; D013121:Spinal Curvatures / Q000150:complications*; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D014549:Urinary Incontinence / Q000209:etiology