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Annular Tear

Annular tears occur when the outer casing of a vertebral disc rips. An annular tear is a condition in which the outer layer of one of the interior discs that cushion vertebrae in the spine develops a tear. A tear in the disc weakens it, increasing the likelihood that the disc could deteriorate further and impinge on a spinal nerve. Annular tears are also called by a variety of other names, including “annular,” “radial,” “concentric,” and “transverse” tears.

Causes
Annular tears occur when pressure on a spinal disc damages or breaks down the once healthy disc, causing it to compress or change its normal shape. Potential causes of this pressure include:

  • Age-related wear and tear, which can lead to Degenerative Disc Disease
  • Back or neck strain due to repetitive physical activity, poor posture, imbalances in the musculature, or heavy lifting
  • Direct physical injury such as a car accident or fall
  • Genetics, whether or not the symptoms appeared in your parents

In some cases, damage only affects the inner layers of the disc’s outer covering and leaves the inside of the disc intact—this describes a bulging disc. In other cases, the outside of the disc tears and the disc’s inside protrudes outward. This is called a disc protrusion or herniated disc.

Symptoms
The symptoms of an annular tear depend on two basic factors: the location or type of the damaged nerve and the amount of pressure placed on that nerve. Common symptoms include:

  • In the lumbar spine: pain, numbness, tingling, burning, and weakness in the back, buttocks, legs, and feet. If impingement affects one of the roots of your sciatic nerve, you can develop sciatica, which is characterized by localized or radiating pain, numbness, or other uncomfortable sensations in the lower body
  • In the cervical spine: pain, numbness, tingling, burning, and weakness in the neck, arms, hands, and sometimes in the head
  • In the thoracic spine (less common): pain, tingling, or numbness radiating through the stomach or chest, which patients often confuse for cardiovascular problems

Prior to having a surgical procedure to treat your annular tear, conservative measures such as physical therapy, chiropractic, and steroid injections should be attempted. If these measures do not meaningfully relieve your pain, a North American Spine procedure may be in order.

Treatment
North American Spine partner physicians have the broadest range of minimally invasive solutions for your back or neck pain. Depending on the location and severity of your pain, your treatment will fall into one of the following categories:

  • Decompression: Minimally invasive decompression surgery aims to relieve pressure on the spinal nerves. This pressure can be caused by many conditions. Using a surgical laser, if necessary, soft tissue will be removed and pressure on nerves will be relieved. For more on decompression, see Decompression.
  • Stabilization/Fusion: Minimally invasive stabilization/fusion surgery aims to restore spinal stability lost to collapsed discs. Diseased material is removed and stability is regained by fusing vertebrae or replacing diseased material with specialized hardware. For more on stabilization, see Stablization
  • Injections: Injections aim to reduce inflammation, block pain, and/or aid in the regeneration of healthy nerve passages. These procedures often are not permanent solutions, but they may be repeated when pain returns. They are extremely quick procedures with virtually no recovery time.
  • Other Procedures: North American Spine partner physicians may suggest other types of procedures, including the placement of a Spinal Cord Stimulator, an implanted device that blocks the pain signals created by a variety of conditions. For more on our other procedures, see Other Procedures.

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