Can a flex circuit also be twisted 45° following the Z axis?
Yes, flex circuits can be twisted, but it depends on the application. The thicker the circuit, the more elongated the twist must be. It would not be possible to grab the circuit in two places a quarter inch apart and twist because that would sheer the circuit. Thicker circuits need longer areas to form the twist without circuit damage. A good reference is that if the circuit can be flexed by hand, it will probably not hurt the circuit. But expect to damage the circuit if you twist it with a tool, such as a vise grip or pliers.