Out for an enjoyable day of shopping last spring, Fanelofe Aiken experienced a deeply private and embarrassing event. She unexpectedly lost control of her bowels and bladder in the store. Much to her surprise, it was a symptom of a serious spinal condition that could be fixed only with surgery.

“I really didn’t have much back pain,” said Ms. Aiken, who is willing to share her story to help others. “But it was very traumatic. It wasn’t a life-or-death situation, but it felt like it. I kept thinking that I could be in an adult diaper for the rest of my life.”

Back pain is the leading cause of disability in the U.S. “About 85 percent of Americans will have an episode of back pain in their lifetime,” explained Jobyna Whiting, M.D., a neurosurgeon and director of degenerative spine surgery at Baptist Health Miami Neuroscience Institute. “While it’s unusual for patients to present with neurological deficit in the absence of pain, like Ms. Aiken, it does happen.”

Dr. Whiting diagnosed Ms. Aiken, 60, with lumbar stenosis and partial Cauda Equina Syndrome. The conditions can occur when the spinal canal in the lower part of the back narrows. As the nerves that communicate with the legs and bladder are compressed, back pain, weakness, sciatic pain and incontinence can result. In Ms. Aiken’s case, the cause was likely degenerative wear and tear.

Many patients with back and neck problems can improve with physical therapy, joint injections and other non-invasive approaches offered by Baptist Health Miami Neuroscience Institute. But others require surgery, or their symptoms can worsen and even become permanent.

“Any instability of the spine, even a micro-instability, can start to limit mobility,” Dr. Whiting said. “Think about how many times a day we bend over, twist, or even roll over in bed. These seem like small and simple movements, but when you are in pain, they can become very difficult.”

When Dr. Whiting was called to Baptist Hospital’s Emergency Center, part of Baptist Health, to consult with Ms. Aiken, she met the whole family — husband Daniel, and sons Daniel Jr. and Devin.

“Dr. Whiting came into my room, she sat with us, explained to us who she was and the procedure that needed to be done,” Ms. Aiken said. “When she told us the surgery involved putting rods and screws in my back, it was so scary that we were quiet for a long time. My husband and sons had questions, and she leaned in and really listened to them. She understood this was a family decision and put us at ease. She is a woman who cares.”

Part of the conversation centered on Ms. Aiken’s blood sugar, which was not under control. As a type 2 diabetic, she was at higher risk for complications such as post-operative infection, wound-healing problems and the failure of the vertebrae to fuse.

Determined to be healthy enough to safely undergo surgery, Ms. Aiken spent a month closely monitoring what she ate and taking her medications. On April 4, 2024, with her blood sugar in the normal range, she had surgery at Baptist Hospital.

Lumbar fusion involves decompressing the involved nerves, removing the disc between the bones, stabilizing the spine by inserting a cage where the disc was and packing the area with the patient’s own bone salvaged during the procedure, and then inserting screws and rods to hold everything in place.

Sophisticated technology in the operating room gives surgeons the best visualization of the spine, Dr. Whiting said. “Using intraoperative navigation, a real-time CT scan shows me exactly where I am placing screws. It allows me to be very precise. We are privileged to have this equipment. Not all hospitals do.”

Recovery from lumbar fusion surgery is lengthy. After five nights in the hospital, Ms. Aiken went to a rehabilitation facility for two weeks, which was followed by in-home therapy. Patients are restricted in activity and how much weight they can lift over a period of months.

“When Dr. Whiting came in to see me the day after surgery, she got me out of bed and said I was a rock star. I told her that I was on a mission. I have a lot of living left to do,” Ms. Aiken said. She felt fortunate to have her mother, husband and sons at her side, as well as her strong faith.

Today Ms. Aiken walks several miles every other day. In addition to helping her strengthen her core and back, walking has benefitted her in other ways. “I’ve lost 8 pounds. They are going to have to watch out when I put on my bathing suit,” she said, laughing. She’s also thrilled to be back at St. Peters Missionary Baptist Church in Perrine, where her father was a pastor for 18 years and where she is one of the leaders in ministry.

While we can’t stop aging and the degenerative changes that occur with it, there are a few things you can do to lessen your chances of a back problem, according to Dr. Whiting. Among them:

·       Strengthen your core. She suggests mat Pilates, in particular.

·       Stay active as you age, but don’t hesitate to modify your exercise intensity to reduce the risk of injury.

·       Don’t smoke – or stop smoking if you do.

·       Keep an eye on your overall health, and if you have chronic health conditions, keep them in check.