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the interior of the car it may produce axial loading of the spine.  Axial loading of the flexed and rotated spine produces force concentration at the postero-lateral corner of the disc and this may result in acute rupture of the annulus with herniation of the disc.

31 Osti O, Vernon-Roberts B, Fraser R (1990) Annular tears and intervertebral disc degeneration. Spine 15:762.

32 Moor R, Osti O, Vernon-Roberts B et al (1992) Changes in the end plate vascularity after an outer annulus tear in the sheep. Spine 17:874.

33 Greenough CG and Fraser RD (1994) Aetiology, diagnosis and treatment of low back pain. Eur Spine J 3:22.

34 Kirkaldy-Willis WH (1983) Managing low back pain. New York, Edinburgh, London, Melbourne, Churchill Livingstone.

35  White AA, Panjabi MM (1990) Practical biomechanics of spine trauma 2nd eds. J. B. Lippincott Co. Philadelphia P-19.

36also known as contusion.

37 Nicoll,EA (1949) Fractures of the dorso-lumbar spine. J. Bone Joint Surg [Br] 31B:376-394.

38Figure 28: Protrusion - herniation of the nucleus through the torn inner layers of the annulus with bulging of the intact outer layers.  Figure 28(2): Extrusion - complete tear of the annulus with extrusion of the nucleus.  The extruded portion still remains in continuity with the part inside the disc.  Figure 28(3): Sequestration - the extruded fragment of the nucleus looses contact with the disc and moves upwards or downwards.

39 Russel T (1989) Thoracic intervertebral disc protrusion: experience of 67 cases and review of literature. Br. J. Neurosurg 3:153-160.

40 Love JG and Schorn VG (1965) Thoracic disc protrusions. J Am Med Assoc. 191:627-631.

41 The importance of cauda-equina syndrome is that this is a rare but definite