This Article Is Part Of A Series Written By Dr. Kevin Pauza
Even if you’re aware that most spine issues are caused by annular tears, it can be difficult to know this for sure because the most common options for diagnosing the cause of spine pain can’t reveal annular tears.
MRI & Annular Tears
The rings of the annulus fibrosus are composed of 22-25 layers. All the sensory nerves reside within these layers. Tears of inner layers cause the gel to leak within the layers, causing inflammation and pain within the disc. This is why a patient’s MRI may look normal while the patient suffers from severe pain. It is difficult for annular tears to be diagnosed by MRI alone.
The reason for this is that MRIs cannot show annular tears. MRIs are only able to show what annular tears lead to, such as disc herniations, bulges, pinched nerves, or degeneration.
It’s important to remember that these herniations, bulges, pinched nerves, or degeneration don’t cause symptoms. Only leaking nucleus pulposus gel as a result of these annular tears causes symptoms.
Discograms are problematic because they lack precision, they’re painful, and at worse, they can lead to an incorrect diagnosis, potentially misleading surgeons into fusing the wrong discs. This is what can lead to Failed back Surgery Syndrome, which unfortunately is fairly common.
In summary, discograms are painful and not precise enough to identify the pain-causing annular tears that need to be repaired.
Can Surgery Solve Annular Tears?
It still surprises some people to learn that research affirms that the pinching of a nerve is not the actual cause of pain, but instead it is the associated inflammation caused by leaking nucleus pulposus gel through annular tears that causes every symptom of sciatica or low back or neck pain.
Remember that if you have a disc bulge, herniation, pinched nerve, or degeneration, annular tears are most likely the underlying cause. These issues can’t be healed until the annular tears causing them are healed.
Unfortunately, surgery cannot heal these tears, and in most cases actually worsens them.
Understanding the origin of the word “annulogram” is helpful in understanding an annulogram. “Annulo” refers to the annulus fibrosus, or the outer portion of the spinal disc, while “gram” refers to a picture, and that’s exactly what an annulogram is: a video image of X-ray contrast flowing through annular tears.
The annulogram test is one of the most accurate ways to diagnose annular tears. According to patients, annulograms are simple, brief, and essentially pain-free.
During the test, an almost microscopic needle is directed into the annulus fibrosus of each disc in the symptomatic region of the low back or neck. Next, a trace amount of x-ray contrast dye combined with an antibiotic is gently injected into the annular layers while using live video to watch for x-ray contrast flow through the annular tears.
Finally, the precise cause of symptoms is identified within minutes.
For patient convenience, at the same time that the annulogram identifies annular tears, the needles remain in place. Next, through those needles, the natural fibrin sealant is introduced into each annulus fibrosus tear, immediately sealing all tears. This combination of the annulogram followed by introducing the fibrin disc sealant at the same time is what’s known as the Discseel® Procedure
The Discseel® Procedure
Dr. Pauza developed the Discseel® Procedure because he recognized that fibrin heals other parts of the human body. With Dr. Pauza’s guidance, the North American Spine Society confirmed that the Discseel® Procedure seals and heals annular tears.