Axial rotation of lumbar intervertebral joints in forward flexion.

This paper examined the mobility of intervertebral joints in axial rotation in a neutral and in two flexed positions. Torsion tests were conducted in vitro on specimens of isolated intervertebral joints in a rig specifically designed to apply torsion without imposing a fixed axis. This permitted the specimens to rotate about their own mobile axis of axial rotation. In addition the specimens were flexed about previously defined physiological axes of sagittal flexion in order to simulate movements as close as possible to those seen in life. It was shown that some intervertebral joints do exhibit an increased ability to rotate when in some degree of sub-maximal flexion dependent on the morphology of the zygapophysial joints. In full flexion axial rotation is limited, most probably by tightening of the posterior ligaments and zygapophysial joint capsules. This study lends evidence to the argument that torsion alone is insufficient to damage the intervertebral disc but a combination of flexion and torsion will increase its vulnerability to injury.