Small Annular Tears and Central Disc Protrusions: Mechanism and Clinical Significance

Small annular tear: A focal tear in the outer annulus fibrosus of an intervertebral disc that does not extend through the full thickness (unlike a herniation).

Central disc protrusion: The inner nucleus pulposus bulges through the annular tear toward the spinal canal midline, potentially compressing the thecal sac or nerve roots.

Together, this describes a contained disc protrusion where nuclear material displaces through a limited annular defect. It can cause radicular pain, sensory changes, or motor weakness if neural structures are compressed. Imaging (MRI) confirms the diagnosis. Management ranges from conservative care to epidural injections or surgery based on severity and neurological deficits.