How are annulus fibrosus tears treated?


The annulus fibrosus is a tough sheath that forms the outside of the intervertebral disc. Your task is to hold and protect the soft material located in the center of the disc. This soft center is called the nucleus pulposus . The nucleus pulposus (and the entire intervertebral disc ) provides cushioning for the spine.

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The annulus, as it is called for short, consists of several concentric rings of fibrous cartilage oriented at a diagonal angle. The fibers of each individual layer of the ring run perpendicular to the fibers of the adjacent ring. This design of the structure increases the resistance of the fibrous annulus as a whole, allowing it to fulfill its function of container of the nucleus pulposus.

The ring breaks

One of the most common injuries to the annulus fibrosus is rupture. Tears can be painful or asymptomatic. Annular tears sometimes cause a bulging or herniated disc, but not always.

Very often, a tear can be successfully treated without surgery; In other words, physical therapy, exercise, holistic therapy, and medication may be enough to relieve symptoms.

In most cases, treatment for an intervertebral disc focuses on containing (or removing pieces) of the nucleus pulposus.

But recently, scientists and doctors have been working on ways to strengthen and / or restore the annulus fibrosus. According to the article Bron et. Alabama. Published in the European Spine Journal, a new regenerative approach that focuses on the integrity of the ring fibers themselves may be needed to prevent recurrent hernia. The authors say that strengthening and repairing the annulus fibrosus may actually increase the repair potential of the nucleus pulposus. Without repair and reinforcement, they continue; normal disc pressure cannot be restored (which is necessary for the main damping task of the disc).

This new direction is in its infancy, which means that while testing is done on animals, effective treatments for humans are still a long way off. Meanwhile, here is Bron, et. a list of possible approaches to strengthen and repair the annulus fibrosus.

Surgical approach for annulus fibrosus repair

Sewn, according to Bron, et. Alabama. designed to support the nucleus pulposus during disc replacement surgery. But it does not repair lost fibers or repair damage. Several products are already used during surgery that address some of these problems, the researchers say; at the same time, they challenge future researchers to develop and improve even more effective methods.

Regeneration of the fibrous ring.

According to Bron, et. etc., a better solution than suture. The problem is that it is much more difficult for scientists to cope. Currently, 3 types of methods are being developed: the creation of ring cells using genes and bioactive factors to influence the production of the extracellular matrix and the creation of scaffolds.

Ideally, the researchers say, a ring regeneration strategy would combine techniques that simultaneously close the tear and regenerate tissue. They also say that genetic and bioactive strategies cannot be used as separate treatments, but in combination with a scaffold.

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