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Difference between annular tear with herniation compared to disc herniation?

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:33 AM in Lower Back Pain
I just got my husbands MRI report. It shows an large annular tear on both the right and left sides of the L5-S1 disc and an annular bulge. What does that mean annular tear? He also has a large disc herniation at L4-L5 but it says nothing about an annular tear that that level. I thought if you have a herniation you have a tear in the disc and that is why the disc material is spilling out.

He also has a disc bulge at L3-L4. His spine is pretty messed up but he is not in pain anymore which is amazing with all of these findings in his MRI. It was taken 3 weeks ago.

My L5-S1 disc has herniated on me many times and there never has been any mention of an annular tear or anything like that in the reports.


  • The disc is formed with a soft gel-like center surrounded by rings of fibrous tissue called the annulus. The annulus can tear without the gel (nucleus) spilling out -- which would be an annular tear. If it tears AND the gel spills out from the disc, this is called a "herniated disc." (or depending on where you live...“disc prolapse”, “ruptured disc”, “slipped disc”, “extruded disc”.

    When a disc herniates it is noted as such and no mention is made of the annular tear, but when it mentions annular tear, it means the disc is still intact, but there is a small split in the tough ligament material, but not affected the nucleus.

    An annular tear can heal on its own, or it can progress, allowing the gel to flow out of the disc, which often causes nerve compression.

  • Gwennie is right,again.Herniation means that the annulus has been torn already.I am in the same situation.L4/5 herniation and L5/S1 annular tear and protrusion.
    Best wishes to you both.
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  • I was sent a link to this website http://www.chirogeek.com/index.htm. Click on anular tear there is some good info in there. Here is a paragraph under radial tears and how they never totally heal and why. They are the ones that extend completely through the anulus:

    Microscopically, radial tears often show vascularization tissue (newly formed blood vessels) and granulation tissue (a form of scar tissue) formation in the periphery. This acts as a ‘plug’ and will stop any migrating nuclear material for escaping or herniating from the disc. Figure #2, show what this tissue plug may look like. Both animal and cadaver studies demonstrate this neovascularization. Animal studies have shown that this vascularized granulation tissue appears within a few months after the artificial creation of an anular tear (Rim Lesion) in the outer anulus. This healing attempt unfortunately never extends deeper han the outer 1/3 of the anulus (5). This lack of complete anular healing is believed directly related to the fact that the inner anulus and nucleus has no direct blood supply and is essentially avascular. This means that it is highly unlikely that complete, full thickness radial tears, will ever completely heal after their conception and will always be subject to re-injury. This incomplete healing may explain the recurrent nature of back pain.
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