The Science
The procedure is a minimally invasive injection that uses an FDA-approved biologic sealant to repair tears in your spinal disks. By sealing them, your disks have a chance to heal naturally—addressing the source of pain instead of just masking symptoms
Anatomy & Pathology
Intervertebral disks lie between and connect the vertebrae of the spine, providing flexibility and shock absorbance. Intervertebral disks are comprised of a tough outer layer comprised of collagen called the annulus fibrosis (AF) which contains a gel-like substance called the nucleus pulposus.
Injury or ageing can cause tears in the annulus fibrosis which allows the gel-like nucleus pulposus to leak out of the intervertebral disk and irritate surroundings nerves via chemical and mechanical mechanisms, causing pain.
Annulograms for Diagnosis
An annulogram is used to diagnose annulus fibrosis tears. To reach the disks, the patient lies on their stomach with mild conscious sedation. A needle is directed into the posterior annulus fibrosus and a contrasting dye is injected into the annulus which allows for the visualization of the leaking disks under fluoroscopy. If a tear is identified, the needle will remain in place while the surrounding disks are visualized in the same manner. Once all the tears have been identified, the affected disks are administered a fibrin sealant, an off-label FDA approved drug.
Fibrin Treatment
The fibrin sealant forms a bio adhesive glue that mechanically seals the annular tears and prevents further leakage. This promotes healing and of the injured disk and
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