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What is toppling sign in spine TB?

Asked by Hutchison 

Toppling sign is one of the four "spine at risk" signs of pediatric Pott's spine to identify children at risk of severe deformity. Normally, in the initial stages of collapse, a line drawn along the anterior surface of the inferior vertebra intersects the inferior surface of the upper normal vertebra. Toppling has occurred when the line intersects above the middle of the anterior surface of the upper vertebra. 

In English, "topple" means to lean forwards and fall. Understanding the real meaning of the word might help understand the deformity.

A. Facet separation 
B. Retropulsion 
C. Lateral translation 
D. Toppling

The other "spine at risk" signs are: 

1. Separation of facet joint 

2. Retropulsion 

3. Lateral translation

Reference: Tuberculosis of the Skeletal System, 6th Edition (SM Tuli)