An annular tear occurs when the tough outer layer (annulus fibrosus) of a spinal disc is ruptured. This can happen as a result of a traumatic injury or can occur gradually, as part of the natural aging process. The cervical (neck) region of the spine is particularly vulnerable to annular tears in people who are approaching middle age or older. This is because the cervical spine supports the weight of the head while being exposed to a wide variety of stress-inducing head and neck movements.

As we age, the discs in the spine that cushion the cervical vertebrae begin to lose water content and become brittle. The outer wall often begins to rupture, which does not cause symptoms on its own. Symptoms will only arise when the gel-like nucleus material known as nucleus pulposus leaks through the rupture and makes contact with an adjacent nerve root or the spinal cord.

Site of nerve compression determines annular tear symptom location

Sustained contact between extruded disc material and a nerve root is known as a pinched nerve or herniated disc. There are eight sets of nerve roots associated with the cervical spine, annotated as C1 to C8. Most annular tears within the cervical region occur at the C5 to C8 levels. The areas of the body affected by the pain, tingling, numbness or muscle weakness caused by nerve compression will depend on the location of the annular tear, as described below:

• C5 — pain or mild numbness in the shoulders, deltoid muscle weakness and reduction in biceps reflex
• C6 — radiating arm pain, biceps weakness, weakness in the wrist extensors, reflex reduction in the muscles of the forearm and numbness in the thumb
• C7 — middle finger numbness, radiating arm pain and diminished reflex in the triceps muscle
• C8 — loss of function in the hand, pain or numbness on the outside of the hand and diminished reflexes in the hand muscles

Treatment for an annular tear in the cervical spine

These symptoms normally can be managed using conservative treatment methods, such as pain medication, exercise and behavior modification. However, if chronic symptoms associated with an annular tear in the cervical spine persist for several weeks or months in spite of conservative treatment, surgery might become an option. If so, contact USA Spine Care to learn how our dedicated team has helped more than 75,000 patients experiencing neck and back pain to find relief.

At USA Spine Care, our surgeons use a less than 1-inch incision and muscle-sparing techniques in order to alleviate symptoms while resulting in a safer and effective alternative compared to traditional open neck surgery.^ To find out if you are a candidate for our minimally invasive spine surgery, reach out to USA Spine Care today and ask for a no-cost MRI review.* We are here to help guide you on your journey to wellness.