What is an annular fissure in the lumbar spine?

An annular fissure in the lumbar spine is a small tear in the hard exterior wall of one of the spinal discs in the lower back. There are five discs in the lumbar (lower) spine and a fissure can occur in any of them (fissures can also occur in the discs in the upper spine or middle of the back). An annular tear often requires treatment.

Annular fissures, regardless of where they occur, are most commonly caused by age-related degeneration. There are three main types of fissures, which are categorized based on the nature of the tear and the layers of the disc it affects. Radial tears begin at the center of a disc and extend through its outer layer. These are most likely to result from regular wear and tear. Sometimes, however, annular fissures can be caused by sudden trauma or injury. The fissures that are most likely to develop from trauma include peripheral tears, which occur solely in the outer layer of a disc’s shell, and concentric tears, which occur between the layers of a disc.

Conservative annular tear treatment options

An annular tear can be quite painful and treatment is often necessary. Medications – both prescription and over-the-counter – can play a valuable role in relieving fissure-related pain. Medications can also be injected directly into the epidural space surrounding the spinal nerve roots to address more severe discomfort that might be caused by disc tissue that’s compressing the nerve root; this treatment is known as an epidural steroid injection.

When treating a patient with an annular fissure, a physician might also recommend gentle, low-impact exercises to help strengthen the muscles in the neck and back, as well as activity modification and short periods of rest as needed.

Annular fissure surgery

It’s not often that an individual needs surgery for an annular fissure, but some people don’t find the relief they need from nonsurgical treatments. When this is the case, it might be beneficial to consult with a surgeon about potential options.

At Laser Spine Institute, we have helped more than 60,000 patients since 2005. We offer several minimally invasive, outpatient procedures that may be a helpful addition to your annular tear treatment plan. To find out if you’re a candidate for our procedures, contact us today.