Fibrosis and Spinal Nerve Compromise (Radiculopathy):

During spinal movement, the individual nerve root slides within its surrounding membranes (dural sleeve).  Any lesion or abnormality that compresses the nerve root, its adjacent sleeve or the surrounding blood supply can result in nerve damage with scar formation inside the spinal nerve, around the nerve root or within the openings along the spine (neuroforamen).  Scar tissue formation between a nerve root and its surrounding dural membranes will inhibit the sliding motion and compromise the elasticity of the nerve root and dural sleeve.

Adhesions between the nerve root and the dural sleeve may result in abnormal tension that can result in a cycle of microtrauma, bleeding, inflammation, and further scar tissue formation.  Chronically inflamed nerve roots become sensitized to compression.  Scar tissue can also compartmentalize or adhere to a nerve root preventing it from moving out of the way of a disc bulge or herniation should occur at the same level.  This increases the risk for nerve injury.

Spinal Joint (Facet) Adhesions:

Any injury or inflammatory condition afflicting a spinal joint (facet) complex can lead to scar tissue formation.  Adhesions can restrict the elasticity/flexibility of joint capsules subsequently restricting the movement of the spinal segment.  This can lead to regional changes including muscle atrophy and increased risk for degenerative disc disease as well as pain.

Scar Tissue and the Intervertebral Disc:

Disc fiber (annular) repair can lead to the formation of granulation or scar tissue within the disc.  Scar tissue/granulomatous tissue within the intervertebral disc can sometimes be visualized on MR imaging with the use of special contrast agents or imaging protocol.