Many authors prefer the term annular fissure over annular tear, as the latter seems to imply acute injury 1,2. In the setting of severe trauma with disruption of the disc, then the term disc rupture should be used. The term annular gap (referring to a relatively wide annular fissure) is non-standard 2.
Most are asymptomatic, however, some are painful. The defect allows an ingrowth of nerve endings and granulation tissue. Fissures near the dorsal root ganglion are especially likely to be painful.
Annular fissures may be radial, transverse or concentric in orientation. The fissure may involve all layers or only some. The distinction is difficult if no disc extrusion is seen.
Although very common, only a minority are identified on MRI and are characterised by a region of high T2 signal (high intensity zone) in the otherwise low signal annulus.
- 1. Costello RF, Beall DP. Nomenclature and standard reporting terminology of intervertebral disk herniation. Magn Reson Imaging Clin N Am. 2007;15 (2): 167-74, v-vi. doi:10.1016/j.mric.2006.12.001 - Pubmed citation
- 2. Fardon DF, Williams AL, Dohring EJ et-al. Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. Spine J. 2014;14 (11): . doi:10.1016/j.spinee.2014.04.022 - Pubmed citation
- spinal anatomy
- congential abnormalities of the spine
- spinal infection / inflammation / degeneration
- intervertebral disc
- intervertebral disc disease nomenclature
- lumbar disc disease
- acute calcific discitis
- acute disseminated encephalomyelitis (ADEM)
- Charcot-Marie-Tooth disease
- HIV vacuolar myelopathy
- HTLV-1 associated myelopathy (tropical spastic paraparesis)
- multiple sclerosis
- neuromyelitis optica (NMO) - (Devic's disease)
- transverse myelitis
- SCA3 (Machado-Joseph disease)
- subacute combined degeneration of the cord
- subacute necrotizing myelopathy
- tabes dorsalis
- spinal ischaemia
- spinal trauma
- spinal tumours and cysts
- spinal vascular malformations