I was just reviewing my MRI results once again and my Chiro noted to me that I have a bulging disk with a tear, but this is what my MRI report says (LARGE print are my personal notes)...to me it looks as though I have a bulging, protruding disk with a tear...doesn't it?
L4-5 - Axials show mild/moderate concentric disk bulging with a superimposed midline posterior disk protrusion **this means a herniated disk**(central or posterior disk protrusion occurs when herniation occurs directly in the midline of the disk**) , associated with some focal subannular signal; compatable with partial annular tear **Annular can be thought of as tiny cracks on the outer wall of the disc. This can be painful**
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I was reading on that very subject and found that a bulge is not a herniation and a tear is not either. I just did a search on bulging discs and it gave me enough info-so many times I have or someone else has said they were one in the same, but they aren't. Also, a bulge can be reabsorbed, where I don't think a herniation can really be helped. But, that also is still a question out there at times.
Mel is right, bulges, herniations, and tears are all different. You can have a tear without having a bulge or a herniation. A bulge is less severe than a herniation. Other than that, I'm not sure what the exact differences are between a bulge and a herniation.
Mel, how is a bulge reabsorbed? I thought that a herniation can fuse itself but never heard that a bulge can be reabsorbed. I have a bulge and was told that there was nothing that could be done for it, just stop twisting so it won't herniate.
a bulge can heal, I have asked and read it. There may be nothing you can DO for it, that doesn't mean it can't heal on it's own. When I had my surgery the first time too, it was a bulge, not a herniation-It didn't heal so they operated.
Protrusion is the same as a bulge it means that the disc is still contained and has not herniated, A tear is simply a tear in the outer lining of the disc that can leak the disc material or not, but once the protrusion or disc opens and becomes an avulsion then it has herniated or lost the inner disc material because the disc has for a lack of better terms blown out kind of like a tire. How is that for a definition?
Hope this helps a little
P.S. It is VERY common for bulges it is kind of like looking at your tire on your car when the air is low and it bulges at the bottom from supporting the weight of the car, that is what a disc basically does is support the weight of our body and if some of the fluid is lost from a small tear that can infact close on its own then it gives more then the rest and you may get a bulge that way or it may be bulging from just getting older called DDD
Bulges are often what happens before a full herniation. As I understand the difference is size. A bulge (when you look at your MRI films) looks as if the disc is slightly larger than the space that it is in. You will also notice a difference in height between the space with a bulge and one without a bulge. Bulges are very common and a lot of times are asymptomatic. Bulges generally occur because of aging. In fact if everyone in the world had an MRI almost everyone would have a level with a bulge.
A herniation looks like the whole disc is about to pop out. Think of holding one of those stress balls that you squeeze. If you hold the ball in your fist and squeeze when a little bit comes out it is a bulge when a lot of it squeezes out it is a herniation.
A tear can be seen with a herniation/bulge or without. The best way to confirm a tear is to have a disco gram with dye. After the dye is injected in the disc they will wait 10-15 minutes and then do a CT if there is a tear the dye will begin to leak out.
I have no idea if my example makes sense; I think the drugs are messing with me today. Let me know if I confused you and I will try again!
PeachJam, first, I don't remember if I welcomed you to the board so, welcome. Second, I have also heard that the majority of people over 30 have at least one bulging disc as well as some DDD. I have two discs in my lumbar that are bulging but I have no problems with them. One frustrating thing about these definitions is that doctors often use them interchangeably with their patients because they don't want to take the time to explain the differences.
A bulge can heal--reabsorb. I know it for a fact because I had one that did so. Herniation cannot heal itself....the disc has come apart when it herniates. A tear can happen with or without a bulge; they, too, can heal themselves.
I found some information for you, thought it might help:
Disc bulge or protrusion results when the disc bulges out from between two vertebrae without rupturing its surrounding envelope, the annulus fibrosis.
Disc prolapse results when the inner jelly-like central part of the disc ( the nucleus pulposis), seeps into the outermost fibers of the surrounding envelope, the annulus fibrosis.
Disc extrusion results when a tear occurs in the surrounding envelope of the disc, and the inner jelly-like central part of the disc leaks out of the disc.
Sequestrated disc is the term used when disc fragments are separated from the disc, coming to lie well outside the disc space in the spinal canal.