What is an Annular Tear?
An annular tear occurs when the tough exterior of a spinal disc (the annulus fibrosus) rips or tears. The discs in the spine serve as cushions between the vertebrae, providing support to the bone structure of the neck and back while also acting as shock absorbers. If too much stress is exerted on a disc, either from the continual performance of everyday activities such as sitting and standing or as a result of sudden trauma, an annular tear can occur.
Types of annular tears
The disc wall is constructed in several layers, each of which can become torn. The nature of the tear and the layers it affects will be the basis for how the tear is categorized:
- Radial tears – Typically caused by the natural aging process, radial tears begin at the center of the disc and extend all the way through the outer layer of the disc wall. These tears can cause a disc to herniate, which occurs when the gel-like center of a disc extrudes through the tear to the outside of the disc.
- Peripheral tears – These tears occur in the outer fibers of the tough outer layer of the disc and are usually brought on by traumatic injury or contact with a bone spur. Peripheral tears can lead to the degeneration or breakdown of a disc in the spine.
- Concentric tears – When a tear occurs between the outer layers circumferentially, it is called a concentric tear. This type of tear is usually caused by injury.
Annular Tear Diagnosis
Following a physical assessment, a spine specialist typically perform one or more diagnostic tests. Annular Tears are usually best seen on a CT discography, which utilizes dye to identify the annular tear. However, CT discography can be painful and not well tolerated. An MRI can be used to visualize disc architecture painlessly; however, in some cases, a tear might not be visible.
Treatments for an Annular Tear
Patients who suspect they could have this condition or any other degenerative spine condition should seek the care of specialist for proper diagnosis and treatment. There are several conservative treatment options for annular tears available that may allow a patient to regain their quality of life, including anti-inflammatories, physical therapy and/or steroid injections. If these measures fail to provide adequate relief, contact our specialists at Spine & Orthopedic Center.