Annular Tear | Annular Tears

The annulus fibrosus is the outer section of the intervertebral discs which help it to maintain its essential shape even when the forces of gravity press it downwards and outwards. The Annulus fibrosus disci intervertebralis, or annulus is composed of type I and type II collagen that is stiff enough to retain the structures semi-rigid shape even as it has enough flexibility for downward compression that gives the structure its cushioning properties for the spine. When this disc is young and healthy, this outer structure is thick and dense enough to hold the spongy gel material structure with its core. This spongy gel material within the core of the disc is known as the nucleus pulposus. Due to injury and wear and tear, the collagen fibers of the annulus may become worn out, to the point that they bend outwards at their weakest points.

This wearing out of the annulus may be described as disc degeneration. The second stage of this disc degeneration disease is known as a prolapse of the disc. This is the point where the disc bulges outwards at its weakest point. Extrusion is the third stage of the disease in which there is an annular tear and the material within the tear breaks through. During the extrusion phase of the disease, the nucleus has passed through the annular tear but still remained within the disc. The third phase of disc disease is known as sequestration or sequestered disc. At the point of sequestration, the material of the nucleus has completely broken through the annular tears and gone outside of the disc. A disc that has gone through all four phases of this disc disease is known as a herniated disc.

Why do annular tears occur? There are several factors which lead to the development of an annular tear in the intervertebral disc. Our genetics, our body mechanics, and even our lifestyle have a role in maintaining the health of our discs, or lack thereof. Our age is also a major factor, albeit the one we have the least control over.

Age: Time wears all machines and organic structures out. When we are young, our bodies manage to withstand the effects of wear and tear and time as it has the ability to produce new healthy tissues faster than the rate in which we wear them out. After our bodies reach physical maturity, though, and the disc vitality erodes from the inside out. Annular tears may develop in the disc, starting at a surprisingly early age.

Lifestyle choices and decisions play a big factor also. A sedentary lifestyle, weakness of the core muscles and back muscles, and poor nutrition may contribute to disc disease. Smoking may cause faster disc degeneration more than perhaps any other factor.

Poor posture can double or even triple the amount of pressure that is exerted on the lumbar spine. Poor posture and body mechanics may stress the lumbar disc beyond a range that they can manage, putting the body at a lumbar herniated sic risk.

There are three types of annular tears: peripheral , concentric, and radial.
  • Peripheral tears - The annulus of the disc are composed of several layers. Some back injuries cause tears in the outer layers of the annulus, making them prone to the degeneration of the disc. When this happens, the condition is known as a peripheral tear.

  • Concentric tears - Injury is also a common cause of this condition also. Concentric tears occur between the layers of the annulus circumferentially.

  • Radial tears - These tears are more likely than the other two to be related to the aging process. These tears extend from the center of the disc and extend all the way through the annulus fibrosus. The completeness of the tear from the inside to the outside causes the nucleus material to spill all the way to the outside of the disc.