An annular tear occurs when the tough exterior (or the annulus fibrosus) of an intervertebral disc rips or tears. Intervertebral discs act 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 placed on a disc (either from continually performing everyday activities like sitting and standing or from sudden trauma), an annular tear can form.
Types of Annular Tears
The annulus fibrosus is composed of several layers, each of which can become torn. The nature of the tear and which layers it affects will determine the type of tear:
- Peripheral tears – These tears occur in the outer fibers of the annulus fibrosus and are usually brought on by traumatic injury. Peripheral tears may lead to the degeneration (or breaking down) of an intervertebral disc.
- Concentric tears – When a tear occurs between the layers of the annulus fibrosus circumferentially, it is called concentric. It is also usually caused by injury.
- 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 may cause a disc to herniate, which occurs when the center nucleus of a disc extrudes through the tear and onto the outside of the disc.
Diagnosing an Annular Tear
Patients usually seek the guidance of a primary care physician or back specialist when experiencing the pain that can be associated with an annular tear. After a physical assessment, doctors typically perform one or more diagnostic test. This condition is usually best seen on a CT discography, which utilizes dye to visualize the annular tear. However, CT discography is painful and not well tolerated by most patients. An MRI can also be used to visualize intervertebral disc architecture painlessly, however sometimes a tear may not be seen.
Patients who suspect they may have this, or any other neck or back condition, should seek the care of a doctor or specialist for proper diagnosis and treatment. Several treatment options are available allowing a patient to regain his or her quality of life.