Annular Tear Overview

An annular tear — also known as an annular fissure — is a rupture or opening in the annulus fibrosus, the tough outer layer of the cushioning discs that sit between the bones in the spine. When the gel-like substance inside the disc leaks out, it can come in contact with spinal nerves and trigger pain.

An annular tear can occur in the cervical spine, creating neck pain, and in the lumbar spine, creating pain or other sensations that may radiate down a single leg or both legs. The pain is often grows worse during lifting or bending motions, sneezing, coughing, sitting and standing.

North American Spine Can Help

If conservative treatments, such as physical therapy and pain medication, have not provided relief for your chronic pain, the next step may be an AccuraScope procedure. North American Spine’s exclusive AccuraScope procedure treats annual tears by repairing the rupture and relieving pressure on the spinal nerves caused by leaking disc fluid. After the outpatient AccuraScope procedure, most patients feel immediate relief and are able to resume light activities the very next day.

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The first step is to pinpoint the true cause of your chronic neck or back pain. Contact a North American Spine patient coordinator at (877) 474-2225 to discuss your symptoms, past treatments and medical history, combined with a free review of your MRI report.

North American Spine specialists can review your case and determine whether the AccuraScope is right for you.

More about Annular Tear

An annular tear, also called an annular fissure, is a rupture or opening in the annulus fibrosus, a tough layer of material that forms the outer portion of the cushioning disc that sits between each bone in your spine. This type of injury can trigger back pain if the material inside of a disc leaks out and comes into contact with nerves in the spinal area. While annular tears typically do not heal completely, relief is possible through treatments that include rehabilitation, physical therapy and medication.

Spinal Disc Anatomy

The annulus fibrosus of each spinal (vertebral) disc is made from a combination of two types of tissue, called type 1 collagen and fibrocartilage. Fibers in this material run in overlapping layers that crisscross at varying angles to provide strength and resiliency. Specialized fibers at the edge of the annulus fibrosus, called Sharpey’s fibers, anchor each vertebral disc to surrounding spinal bone tissue. The interior of each disc contains a viscous, gel-like substance called the nucleus pulposus, which gives the disc its cushioning properties.

Annular Tear Causes

Most annular tears form in the discs associated with the lumbar vertebrae in your lower back or the cervical vertebrae in your neck. In some cases, these tears stem from accidents or from traumatic injuries like those sustained in sports such as ice hockey, rugby, football or gymnastics. However, in most cases, a tear develops as a result of age-related wear and tear on your vertebral discs. Doctors sometimes refer to this gradual erosion of structural integrity in your cushioning discs as degenerative disc disease.

Annular Tear Description

You can develop an annular tear if the fibers in the annulus fibrosus separate from each other abnormally; if the Sharpey’s fibers that normally anchor the disc get pulled loose from spinal bone tissue; or if the fibers in one or more layers of the annulus fibrosus break. Technically speaking, an annular tear occurs if the nucleus pulposus from a disc’s interior does not extend past the vertical edges of the surrounding spinal bones. If this material extends beyond the bone edges, doctors refer to the resulting condition as a disc herniation, or herniated disc. A disc can also extend beyond the spinal bones, or herniate, without a tear in the annulus fibrosus.

Annular Tear Symptoms

Potential symptoms of an annular tear include back pain, neck pain and pain that appears in a single leg or simultaneously in both legs. This pain typically worsens if you perform lifting or bending motions, or sneeze or cough. In many cases, the pain from an annular tear increases when you sit down and decreases when you stand. As a rule, people with annular tears don’t have any associated compression of the spinal nerves or any other form of structural nerve problem.

Annular Tear Treatment

Once an annular tear forms, it has little chance of healing beyond the formation of a minor amount of scar tissue. For this reason, people with this type of disc damage run a continual risk of reinjuring themselves and triggering recurring contact between the irritating nucleus pulposus and nearby nerves. However, with appropriate post-injury rehabilitation and physical therapy, most people with annular tears can eventually return to a more or less normal physical routine. In the short term, use of an oral nonsteroidal anti-inflammatory medication (NSAID) can help ease pain and any associated inflammation. In a small number of cases, people with herniated discs require surgery to fully address their condition.

Take the Next Step

Contact a North American Spine patient coordinator today. Use the Ask An Expert form on this page or call us at (877) 474-2225.