An annular tear occurs when the tough exterior of an intervertebral disc (the annulus fibrosus) rips or tears. Intervertebral discs 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 annulus fibrosus is constructed of 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 annulus fibrosus. These tears can cause a disc to herniate, which occurs when the center nucleus of a disc extrudes through the tear to the outside of the disc.
- Peripheral tears – These tears occur in the outer fibers of the annulus fibrosus and are usually brought on by traumatic injury or contact with a bone spur. Peripheral tears can lead to the degeneration or breakdown of an intervertebral disc.
- Concentric tears – When a tear occurs between the layers of the annulus fibrosus circumferentially, it is called a concentric tear, which is usually caused by injury.
Diagnosing an annular tear
Patients usually seek the guidance of a primary care physician or back specialist when experiencing pain that could be associated with an annular tear. Following a physical assessment, physicians typically perform one or more diagnostic tests. This condition is 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 intervertebral disc architecture painlessly; however, in some cases a tear might not be visible.
Patients who suspect they could have this condition, or any other degenerative neck or back condition, should seek the care of a physician or specialist for proper diagnosis and treatment. Several treatment options are available to allow a patient to regain his or her quality of life.