What is an Annular Fissure?

In an annular fissure the outer part of the disc, which is made of strong fibers arranged in concentric layers, begin to fray, break or separate from the bone to which they are attached.

Is an annular fissure the same as an annular tear?Sort of. The terms fissure and tear are sometimes used interchangeably. However, anannular tearis typically the result of trauma to the spine, whereas a fissure is a wear-and-tear injury.

Is an annular fissure the same as an annular tear?

Sort of. The terms fissure and tear are sometimes used interchangeably. However, anannular tearis typically the result of trauma to the spine, whereas a fissure is a wear-and-tear injury.

How Tears to the Annulus Fibrosus Are Treated

Does Annular Fissure Cause Pain?

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Annular Fissure Diagnostic Procedures

Getting an annular fissure diagnosed involves a medical history, physical examination, and diagnostic tests. (Your healthcare provider may prescribe pain medication and physical therapy before trying the tests)

As far as these tests go, they may include an X-ray, MRI, CT scan and/or discography, including provocation discography where a contrast dye is injected to purposely elicit your pain. If you feel pain in the area where the dye is injected, your healthcare provider may confirm an annular fissure After your provocative discography, there may be other tests to further hone and describe the affected area.

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Treatment for Annular Fissure

Bao-Gan Peng reports in his article for the 2013 issue of theWorld Journal of Orthopedics, entitled “Pathophysiology, diagnosis, and treatment of discogenic low back pain,” that there’s little consensus among healthcare providers and therapists as to the best way to treat a fissure.

Frequently Asked Questions

If these measures fail to bring relief, your healthcare provider may suggest a steroid injection in the injured disk. In some cases, disk replacement surgery is needed.

Possibly, but only after more conservative treatments have failed. An annular tear on its own is not an indication for disk replacement surgery. However, if degenerative changes to the disk are severe, surgery is often needed to relieve the pain and restore mobility.

3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brinjiki, W., Luetmer, P.H., Comstock, B. Bresnahan, B.W., Chen, L.E. Deyo, R.A., Halabi, S., Turner, J.A., Avins, A.L., James, K., Wald, J.T., Kallmes, D.F., Jarvik, J.G.Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173.Bao-Gan Peng.Pathophysiology, diagnosis, and treatment of discogenic low back pain.World J Orthop. 2013 Apr 18; 4(2): 42–52.Yue JJ, Telles C, Schlösser TP, Hermenau S, Ramachandran R, Long WD.Do presence and location of annular tear influence clinical outcome after lumbar total disc arthroplasty? A prospective 1-year follow-up study.Int J Spine Surg.2012;6:13-7. doi:10.1016/j.ijsp.2011.09.001Additional ReadingAmrani, J. Disc Tear (Annular Tear) Spine Doctor website. Accessed Dec 2015.

3 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brinjiki, W., Luetmer, P.H., Comstock, B. Bresnahan, B.W., Chen, L.E. Deyo, R.A., Halabi, S., Turner, J.A., Avins, A.L., James, K., Wald, J.T., Kallmes, D.F., Jarvik, J.G.Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173.Bao-Gan Peng.Pathophysiology, diagnosis, and treatment of discogenic low back pain.World J Orthop. 2013 Apr 18; 4(2): 42–52.Yue JJ, Telles C, Schlösser TP, Hermenau S, Ramachandran R, Long WD.Do presence and location of annular tear influence clinical outcome after lumbar total disc arthroplasty? A prospective 1-year follow-up study.Int J Spine Surg.2012;6:13-7. doi:10.1016/j.ijsp.2011.09.001Additional ReadingAmrani, J. Disc Tear (Annular Tear) Spine Doctor website. Accessed Dec 2015.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Brinjiki, W., Luetmer, P.H., Comstock, B. Bresnahan, B.W., Chen, L.E. Deyo, R.A., Halabi, S., Turner, J.A., Avins, A.L., James, K., Wald, J.T., Kallmes, D.F., Jarvik, J.G.Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173.Bao-Gan Peng.Pathophysiology, diagnosis, and treatment of discogenic low back pain.World J Orthop. 2013 Apr 18; 4(2): 42–52.Yue JJ, Telles C, Schlösser TP, Hermenau S, Ramachandran R, Long WD.Do presence and location of annular tear influence clinical outcome after lumbar total disc arthroplasty? A prospective 1-year follow-up study.Int J Spine Surg.2012;6:13-7. doi:10.1016/j.ijsp.2011.09.001

Brinjiki, W., Luetmer, P.H., Comstock, B. Bresnahan, B.W., Chen, L.E. Deyo, R.A., Halabi, S., Turner, J.A., Avins, A.L., James, K., Wald, J.T., Kallmes, D.F., Jarvik, J.G.Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173.

Bao-Gan Peng.Pathophysiology, diagnosis, and treatment of discogenic low back pain.World J Orthop. 2013 Apr 18; 4(2): 42–52.

Yue JJ, Telles C, Schlösser TP, Hermenau S, Ramachandran R, Long WD.Do presence and location of annular tear influence clinical outcome after lumbar total disc arthroplasty? A prospective 1-year follow-up study.Int J Spine Surg.2012;6:13-7. doi:10.1016/j.ijsp.2011.09.001

Amrani, J. Disc Tear (Annular Tear) Spine Doctor website. Accessed Dec 2015.

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