“A deep ache that never fully goes away.”
A split in the tough outer ring of the disc. It is the specific problem this procedure was designed to treat.
A torn annulus is what the annulogram looks for and where fibrin sealant is placed.
Whatever the diagnosis on your report says, the treatable question is whether a disc is torn and leaking. An annulogram answers that directly — and a review of the MRI you already own is where it starts.
How the procedure worksAn annular tear is a split in the annulus fibrosus — the ring of tough, layered fibres that holds a spinal disc's soft centre in place. It is the specific finding the FibraDisc Procedure was designed around, and the one an MRI is least reliable at showing.
What an annular tear is
Every disc has two parts: a gel-like centre and a ring of many thin, tough layers around it. The ring carries load and keeps the centre contained. Wear, repeated strain, or a single injury can split those layers.
Tears are described by their direction. Radial tears run from the centre outward; concentric tears run between layers; rim tears sit at the edge where the ring meets bone. A disc can have more than one, and the ring's outer layers have a limited blood supply, so tears are slow to close.
How it tends to feel
The classic pattern is a deep, central ache in the low back or neck that never fully settles. It is often worse with sitting, bending forward, coughing, or the first minutes after standing up, and better lying down.
When material from the disc's centre reaches the nerve root beside it, pain can also travel into a leg or an arm without anything visibly pressing on the nerve. Symptoms can shift from side to side or come and go over weeks, which is one reason tears are so often blamed on muscles.
What imaging shows — and misses
An MRI shows disc shape, height, and hydration. A tear sometimes appears as a small bright spot at the back of the disc, but many tears do not show at all, and a report that reads “mild degenerative change” or “unremarkable” does not rule one out.
The annulogram is the test built for this question. Contrast is introduced into each disc under live imaging; a torn disc leaks where an intact one does not. It is performed on the day of the procedure and decides which levels are treated.
How the FibraDisc Procedure addresses it
The procedure places fibrin sealant — a biologic already used in surgery — directly into the tear through a needle, at the levels the annulogram shows are leaking. No incision is made, no hardware is implanted, and no disc or bone is removed, so every surgical option remains open afterwards.
Fibrin sealant's use inside the disc is off-label; the published evidence is pilot and observational data; outcomes vary and are not guaranteed.
When it is not the answer
Progressive weakness, loss of bladder or bowel control, infection, cancer involving the spine, or marked instability all point elsewhere and need prompt care from the right specialist. A tear that is not leaking on the annulogram is not treated. And pain whose source turns out to be a facet joint or the sacroiliac joint is a different problem with a different treatment — we will say so.
Questions about annular tear
The outer layers of the ring have a limited blood supply, so tears are slow to close and can stay open for a long time. Some settle with time and conservative care; others keep leaking. Imaging cannot tell you which, which is why persistent pain after months of conservative care is the point at which an annulogram becomes worth considering.
It is not right for everyone. We will say so.
Often a good fit
- Chronic low back or neck pain that has not resolved with conservative care
- A recent MRI showing disc degeneration, bulging, or herniation
- Pain after a failed spine surgery, including fusion
- You have been told fusion is the next step and want another option first
- You want to avoid hardware and preserve your own disc
Not a fit, or not yet
- No recent MRI — we cannot assess you without imaging
- Progressive weakness, foot drop, or loss of bladder or bowel control (seek care now)
- Active spinal infection or cancer involving the spine
- Severe spinal instability or high-grade slippage
- Expecting insurance to cover it — the procedure is self-pay
Is your annular tear actually a torn disc?
A physician screens the MRI you already have and tells you in writing whether you appear to be a candidate — before you spend anything, least of all a flight.