| Definitions: Annular Tear |
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Definition The annulus is the fibrous ring of the disc structure which surrounds the centrally located soft nucleus of the disc. The nucleus and annulus function together to create a pressurized structure that acts as a shock absorber. The annulus is a ligament and like any ligament in the body can be torn. Tearing of the annulus can produce pain because the annulus has pain fibers within its structure. Many episodes of low back pain are probably tears in the annulus. Diagnosis The diagnosis of annular tearing can be made on MRI imaging but the definitive diagnosis is made on CT-discograms where dye is injected into the nucleus of the disc leaks out into the torn area of the annulus. Non-Surgery Treatment Treatment can consist of time to reduce symptoms, physical therapy, bracing, medications, etc. Surgical Treatment In very selected situations, the symptoms from the annulus may be treated with intra-discal electrothermal treatment. Occasionally, patients have enough persistent pain from annular tears and internal disc disruption to undergo a fusion of the disc space at the level of the tear. Prognosis The prognosis of annular tears is generally the prognosis of low back pain. Annular tears can be the precursor of the herniated disc. |