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What is posterolateral annular fissure?
An annular fissure is a type of discogenic condition that affects the spine. It usually occurs when the fibers that make up the tough outer covering of the intervertebral disc either break or separate. Collectively, these fibers are known as the annulus fibrosus.
What is an annular fissure at L4 L5?
The annular tear is a tearing of the disc external surface that may occur with the aging process or with injury. The L4-5 and L5-S1 discs are the most commonly affected. The annulus may thin or bulge or weaken to the point that disc material may extrude into the spinal canal.
Is an annular fissure serious?
In some cases, annular tears cause no pain or symptoms, and you may not know you have one. However, repeated pressure on a torn, damaged disc can cause a more severe tear. Torn discs can cause further complications, like a bulging disc or disc herniation.
What is the treatment for an annular fissure?
Typically, simple symptomatic annular fissures without disc herniation are treated with non-steroidal anti-inflammatory medications and low-impact physical therapy. Chronic pain due to annular fissures can be due to granulation tissue or in-growth of nerve endings which is usually seen near the dorsal root ganglion.
Does annular fissure require surgery?
Annular tears can heal on their own, but it might take anywhere from 18 months to two years for them to do so. Physical therapy and medicine, both conservative, can aid. If traditional treatment approaches and therapeutic pain management techniques fail to relieve pain, minimally invasive surgery may be required.
Can annular fissure heal?
Often, annular tears will heal on their own when given sufficient time. In the meantime, your doctor may prescribe pain medications, such as ibuprofen, or steroid injections into the disc to relieve inflammation.
Do annular fissures heal?
What causes an annular fissure?
An annular fissure is a condition that affects intervertebral discs. Most of the time a fissure is caused by degenerative changes in the spine, including age-related drying out of the discs, but it can also be brought about by trauma.
Are annular tears caused by trauma?
Repetitive lifting or twisting motions, a traumatic injury, and excess body weight can also cause annular tears.
What makes an annular tear worse?
Without proper care and treatment, an annular tear will continue to worsen. When that happens, the following complications can occur. Herniated disc. Continued stress and pressure from daily activities, sports, or heavy lifting can eventually cause a torn disc to herniate.
What is the posterolateral annulus fibrosus?
The posterolateral (back and side) portion of the annulus fibrosus has collagen fibers that are oriented in a more vertical direction, making this region weaker and more susceptible to fissures. Consequently the posterolateral annulus is where the majority of annular fissures occur.
What is an annular fissure in the lumbar?
What is an annular fissure in the lumbar spine? An annular fissure in the lumbar spine is a deficiency of one or more layers of the annulus fibrosus (outer covering the lumbar disc). The disc has an inner part, called the nucleus pulposus. The outer part, the annulus fibrosus bascially contains the inner part (nucleus pulposus).
What is an annular tear at the L4 L5 vertebral level?
An annular tear at the L4–L5 vertebral level is an extremely common form of spinal degeneration. As the spine ages, the pressure of increased body weight and years of repetitive motions begin to wear down the components of the spine, placing pressure on the vertebrae and compressing the discs.
What is the role of discography in the diagnosis of annular fissure?
Discography (introduction of contrast into the nucleus pulposus) can help distinguish partial thickness or full thickness annular fissure, although the clinical relevance of this is disputed.