• Demetrious J

• Adult
• Intervertebral Disc / diagnostic imaging
• Intervertebral Disc / injuries
• Manipulation, Spinal
• Traction

Purpose: Annular tears of intervertebral discs represent potential pain generators and have been implicated in the development of degenerative disc changes. Symptomatic, physiologic, diagnostic and therapeutic observations will be made related to a patient with an MRI confirmed cervical annulus fibrosus tear.

Methods: A 30-year-old female patient presented for chiropractic care with insidious onset discogenic cervical spine pain, scapular and radicular symptoms. Review of magnetic resonance images revealed a high intensity zone consistent with granulation tissue of a C6/7 annulus fibrosus tear. The patient was treated using spinal manipulation, intermittent axial traction and self care instructions. Clinical outcomes were measured using the Neck Bournemouth Questionnaire and numeric pain scales. A brief review of the related literature is provided.

Results: A patient exhibiting discogenic and radicular symptoms with an identified annulus fibrosus tear of the cervical spine reported relief of painful symptoms and improved activities of daily living via chiropractic spinal manipulation, intermittent axial traction and self-care recommendations.

Conclusion: The presence of an annular tear that was visualized on MRI may have been causally related to the patient’s signs and symptoms. A regimen of spinal manipulation, intermittent axial traction and compliance to self-care recommendations led to the resolution of discogenic and radicular symptoms. The clinical relationship and relevance of symptoms, signs, known physiologic tenets, imaging findings and therapeutic measures may be best considered as multi-factorial and inter-related components.

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