How Serious is an Annular Tear?
Annular Tear Overview
An intervertebral disc is a ligament that connects your vertebrae to one another. Think of it as the glue that holds the spine together. These discs work to keep your bones from rubbing against each other and also help absorb shock. Inside these vertebral discs, the nucleus, is a jelly like fluid. Surrounding the jelly like fluid is called annulus fibrosus. The perfect example of this is a jelly doughnut. The fried dough on the outside is like that annulus fibrosus and the inside of the doughnut is the jelly which is the fluid. The main goal of the annulus fibrosus is to protect the jelly fluid like substance from escaping.
One of the most common problems with the annulus fibrosus wall is when there are tears. These tears almost always happen from the inside out near the nucleus. This is what we call an Annular tear. One of the biggest issues with an annular tear is the ability for the tear to worsen. At first if you have a minor annular tear it will not cause any problems. As time progresses and the tear starts to get bigger, there is a high chance for the liquid in your nucleus to pour out. When this happens you can experience chronic back pain symptoms from this liquid impinging on your nerves.
Three Types of Annular Tears
- Concentric Tears – A tear occurs in the layers of the outer wall (annulus fibrosus) circumferentially or causing the layers to either fully or partially separate.
- Peripheral Tears – A tear occurs in the outer fibres of the outer wall (annulus fibrosus). This is often caused by an injury since the tear doesn’t come from the inner layer. However, it may eventually cause the inside to deteriorate as well.
- Radial tears – A tear occurs first in the inner layer of the disc and gradually tear through the outer layer. This condition can eventually involve a herniated disc condition if the inner core (nucleus pulposus) pushes out of the outer wall (annulus fibrosus).
Causes of an annular tear
An annular tear is a very common spine condition that aging adults have. In fact the leading cause of an annular tear is due to the normal aging process. After the age of 30, your vertebral discs start to degenerate, Other things can cause an annular tear such as lifting lots of weight incorrectly, body weight, and motions that can tear your annulus fibrosus. A common cause of an annular tear can be a car accident. If you believe that you may have an annular tear it is best to get it checked out as soon as possible. There may be no symptoms if you have an annular tear if it is minor, but doing certain things to aggravate it can have long term damaging effects on your spine health and your health in general.
How to find out if you have an annular tear
The best way to find out if you do have an annular is to get an MRI scan. Some annular tears may not be picked up by an MRI scan where a CT discogram may be needed which dye is used to show the tears. Finding out if you have an annular tear because prevention is better than a cure. If you can stop yourself from potentially aggravating that tear to where the disc can bulge or even turn into a herniated disc the better chance you will have to avoid having surgery.
A great treatment approach for annular tears is go try conservative therapy treatments such as physical therapy and chiropractic care with a combination of anti-inflammatory medications and muscle relaxers. A lot of the time this type of conservative treatment helps get some pain relief. If the numbness, tingling, and burning sensation does not go away, interventional pain procedures such as an epidural steroid injection may help you get the relief you need. Annular tears can heal on its own but the process takes a very long time 18 months to two years. The conservative therapy approach is a way to help you get there. During that time span, you must watch everything you do so you do not aggravate the tear and make it worse. If the conservative treatment options and interventional pain management procedures do not work, minimally-invasive surgery may be needed. Some of the surgeries that we can do at Florida Surgery Consultants is a procedure called an endoscopic discectomy where the neurosurgeon goes and removes the disc fragment in the annular tear. A more complex surgery can be done such as a spinal fusion where the neurosurgeon takes out the damaged disc and replaces it.