Every patient contemplating back treatment should first identify their pain source with an annulogram. Today, some physicians rely on the more primative discogram. MRIs are helpful in identifying bulges and degenerated discs but they are unable to identify disc tears. Physicians recommending fusions without annulograms or discograms lack insight, thus jeopardizing your long-term relief. 

This is why most people know someone who is no better following spinal surgery, and one of many reasons for the limited long-term success of fusions. Research confirms that even a minimally invasive discectomy may weaken your disc, accelerating disc degeneration.


Even if you’ve already suffered unsuccessful surgery, or failed all prior pain management procedures and therapies to help relieve your pain, Dr. Pauza believes an annulogram is the best test to evaluate if you have torn discs. It determines if your normal or abnormal-looking discs are leaking. Often, neck pain and lower back pain goes mistreated only because this gold standard test isn’t performed.

Your discs are cushions between your spine’s bones, which are like jelly filled doughnuts, with an outer layer surrounding the jelly-like substance in the center of the disc. The outer layer of the discs are composed of 22-25 rings that can tear whether from an abrupt injury or everyday wear and tear over time. When tears occur, the nucleus pulposus gel that lies within the center of the disc leaks through these tears like a “rat in a rat maze.” It’s important to be aware that the body recognizes the nucleus pulposus as a foreign substance, so when it leaks through these annular tears, it causes inflammation and pain within the discs because of the sensory nerves that reside within these layers and sometimes this gel leaks all the way through the disc and inflames the spinal nerves causing sciatic pain. 

During an annulogram, water soluble contrast is injected into your disc. While Dr. Pauza injects the contrast into your discs he utilizes live X-ray which demonstrates the flow of contrast identifying any tears within each disc or confirming if the disc is normal. Following the Annulogram, Dr. Pauza injects Fibrin, an FDA-approved substance used off-label, into each torn disc to seal and heal confirmed annular tears. To learn more about the Discseel® Procedure, click here.

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