“A deep ache that worsens when you sit.”
Disc height loss, drying, and inflammation — usually with annular tearing that an MRI does not show clearly.
The classic case where imaging under-reports what is torn.
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 worksDegenerative disc disease is not really a disease — it is the label for a disc that has lost height and hydration, with the tearing and inflammation that usually come with it. It is written on a great many MRI reports, and on its own it explains very little.
What it is
With age and load, the disc's centre loses water and the ring develops tears. The disc thins, the vertebrae move closer together, and the joints behind the disc take more load. Most people over forty have some of this on an MRI, pain or not.
The term describes the appearance. It does not say whether the disc is torn and leaking, which is the question that matters for treatment.
How it tends to feel
A deep ache in the low back or neck that worsens with sitting, bending, and lifting, eases when lying down, and flares without an obvious reason. Stiffness in the morning. Pain that has become chronic — present for more than three months — and has outlasted physical therapy, injections, and medication.
What imaging shows — and misses
An MRI shows height loss, darkening of the disc, and sometimes changes in the adjacent bone. It does not reliably show which of several degenerated discs is torn and leaking — and in a spine where three levels look similar, that is the whole question.
The annulogram tests each disc in turn: torn discs leak, intact ones do not. It is how the levels to treat are chosen.
How the FibraDisc Procedure addresses it
At the levels the annulogram shows are leaking, fibrin sealant is placed into the tears through a needle. The disc is not removed and the level is not fused, so the levels above and below are not loaded the way they are after a fusion. The intent is to address the leak, not to return the disc to a younger shape.
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
A disc that has collapsed completely, a spine that is unstable or has slipped forward significantly, or pain that comes from the facet joints rather than the disc each need a different approach. Where the annulogram shows no leak, the disc is not treated — and we will tell you what we think is going on instead.
Questions about degenerative disc disease
Because the appearance and the pain are two different things. Degenerated discs that hurt are frequently the ones with tears leaking material onto the nerve beside them; degenerated discs that do not hurt are generally not leaking. The annulogram is the test that separates the two.
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 degenerative disc disease 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.