A mesh implant repairs annular defects in a spine. The mesh might include natural or synthetic or biocompatible materials. The mesh implant may be placed using peri-annular or intra-annular techniques. In one embodiment, the mesh has tails configured to thread through perforations made in the endplates of vertebral bodies above and below the affected annulus. The surgeon might place the implant using manual or instrument-assisted placement techniques.