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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does The Finding "multiple Posterior Annual Tears" In The X-ray Mean Ruptured Disc?

My husband had an MRI. His doctor got the radiology report and told him it just showed two bulging discs which he has had all his life. He wasn't getting better after a month and it was excruciating so he made an appointment with a surgeon who looked at the disk from the mri and told him he had a ruptured disc that was leaking spinal fluid on the nerve sacs and did emergency surgery immediately. We went back to our other doctor again and had him look at the report again and again he said the radiology report doesn't show a ruptured disc, so I called the radiologist and they said that the statement "multiple posterior annual tears" means a ruptured disc. I want to know who is wrong here. This should have been caught immediately.
Fri, 26 Sep 2014
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Radiologist,  's  Response
Hi,
Thanks for writing in.

I understand your concern. It might be important to see the images before coming to a conclusion. A ruptured disc is a disc which is in later stages of bulging and which may cause pressure on nerve roots leading to pain. It does not cause leakage of spinal fluid and I cannot understand this point. An annular tear is a specific pattern of disc degeneration and might not always be associated with complete disc rupture, I mean there can even be partial disc bulge with annular tears. It is the disc fragmentation which might be a consequence of rupture which needs to be assessed. So the answer to your query might be that its not leaking spinal fluid but pressure on nerve sacs which was released by surgery and this was done to benefit the patient.
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Does The Finding "multiple Posterior Annual Tears" In The X-ray Mean Ruptured Disc?

Hi, Thanks for writing in. I understand your concern. It might be important to see the images before coming to a conclusion. A ruptured disc is a disc which is in later stages of bulging and which may cause pressure on nerve roots leading to pain. It does not cause leakage of spinal fluid and I cannot understand this point. An annular tear is a specific pattern of disc degeneration and might not always be associated with complete disc rupture, I mean there can even be partial disc bulge with annular tears. It is the disc fragmentation which might be a consequence of rupture which needs to be assessed. So the answer to your query might be that its not leaking spinal fluid but pressure on nerve sacs which was released by surgery and this was done to benefit the patient.