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Pelvic Floor Symptoms and Spinal Curvature in Women
Isuzu Meyer1, Tatum A McArthur, Ying Tang
1From 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.
Objectives:
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]).
Methods:
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.
Results:
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).
Conclusions:
The current study shows that the T and L spinal curvatures are not associated with the presence of PF symptoms.
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