Annular Tear in the Cervical Spine
An annular tear occurs when the fibrous outer wall (annulus fibrosus) of an intervertebral disc is ruptured. This can happen as a result of a traumatic injury or can occur gradually, as part of the natural aging process. The cervical (neck) region of the spine is particularly vulnerable to annular tears in people who are approaching middle age or older. This is because the cervical spine supports the weight of the head while being exposed to a wide variety of stress-inducing head and neck movements.
As we age, the intervertebral discs that cushion the cervical vertebrae begin to lose water content and become brittle. The outer wall often begins to rupture, which does not cause symptoms on its own. Only when the gel-like nucleus material (nucleus pulposus) leaks through the rupture and makes contact with an adjacent nerve root or the spinal cord will symptoms arise.
Site of nerve impingement determines symptom location
Sustained contact between extruded disc material and a nerve root is called impingement, also known as a pinched nerve or herniated disc. There are eight sets of nerve roots associated with the cervical spine, annotated as C1 to C8. Most annular tears within the cervical region occur at the C5 to C8 levels. The areas of the body affected by the pain, tingling, numbness or muscle weakness caused by nerve impingement will depend on the location of the annular tear, as described below:
- C5 – pain or mild numbness in the shoulders, deltoid muscle weakness, reduction in biceps reflex
- C6 – radiating arm pain, biceps weakness, weakness in the wrist extensors, reflex reduction in the muscles of the forearm, numbness in the thumb
- C7 – middle finger numbness, radiating arm pain, diminished reflex in the triceps muscle
- C8 – loss of function in the hand, pain or numbness on the outside of the hand, diminished reflex in the hand muscles
Treatment for an annular tear in the cervical spine
These symptoms normally can be managed using conservative treatment methods, such as pain medicine, exercise, behavior modification and others. However, if chronic symptoms associated with an annular tear in the cervical spine persist for several weeks or months in spite of conservative treatment, surgery might become an option. If so, contact Laser Spine Institute to learn how our orthopedic surgeons have helped tens of thousands of patients experiencing neck and back pain to find relief through effective, minimally invasive procedures performed with advanced techniques.