Carolyn is on top of the world after spine surgery at Inova

Carolyn Bivens has seen the world. As an advertising executive for USA today, and later president of Initiative Media, Carolyn traveled all over the globe – sometimes 200,000 miles a year – throughout her 35-year career. But beginning in 2015, back and leg pain began to slow her down.

Carolyn was diagnosed with spinal stenosis and lumbar radiculopathy, which is compression of the nerves in the spine causing pain that radiates from the lower back down into the legs. She was concerned about having surgery, because she had read that spinal surgery wasn’t always effective in cases like hers. For years, she toughed it out with nonsurgical treatments, including steroid injections. They helped at first, but she began to need them more and more often: every six months, then every three months, and eventually every two months – with lots of pain in between.

“My quality of life was diminished. I dreaded going to bed, and I dreaded getting out of bed. Every morning, I crawled on my hands and knees across the bedroom floor because I couldn’t walk without pain,” Carolyn said. This was not the active retirement she had hoped for – in fact, she wasn’t able to do any of the activities she loved anymore. “It was no way to live,” she said.

Carolyn moved to Northern Virginia in 2019 and connected with physicians at Inova Health System. In 2022, she called her primary care doctor for help with her back pain. “I was ready to do whatever I had to do to feel better,” she said. Her primary care doctor conducted a spine evaluation and ordered some imaging, then referred her to neurosurgeon Andrew Fanous, MD, FAANS, Section Chief of Neurological Surgery, Inova Alexandria Hospital and participating member of the Inova Spine Program.

Carolyn noticed a difference from the moment she met Dr. Fanous. “I had had a lot of X-rays already, but Dr. Fanous really dug into my medical history, got a fresh MRI and conducted a thorough evaluation and physical examination. That was the first step,” she said.

“Carolyn had a spondylolisthesis, which means two of the bones in her spine were slipped and not properly aligned over each other. As a result of that slip, she had severe nerve compression, which resulted in serious back and leg pain, as well as weakness in her legs when she tried to walk,” Dr. Fanous explained.

In addition, Dr. Fanous found that she had developed a herniated disc in her spine. Because of her worsening leg weakness, Dr. Fanous recommended surgery to relieve the spinal stenosis and give the nerves more room.

The traditional surgical repair for spondylolisthesis is an open surgery, cutting through the back muscles and working next to the nerves. Dr. Fanous recommended a more advanced technique, however. “We decided to use a minimally invasive approach for Carolyn. That method is a two-stage surgery. First, we go through the abdomen and repair the slipped bones. Then, we use tiny incisions and minimally invasive instruments to put four small screws and two rods in the back to make the repair permanent,” Dr. Fanous said.

Over the following few weeks, Dr. Fanous’s team prepared Carolyn for surgery, explaining to her what to expect, conducting a preprocedural evaluation and connecting her with other members of the team. The care, Carolyn said, was seamless – even coordinating with other providers to make sure her rheumatoid arthritis was accounted for in the treatment plan. “Everything was handled within the Inova Spine Program. It was all part of giving me the best chance to heal quickly,” Carolyn said. “The team took my whole medical history into account, and I know their being able to manage that was one reason I was able to heal so completely.”

In March 2022, Dr. Fanous performed the two-stage surgery at Inova Alexandria Hospital. When Carolyn woke up after surgery, she immediately noticed a difference. “I was wiggling my toes and thought, ‘It doesn’t hurt!’ They got me up to walk immediately after surgery, and I had no pain,” Carolyn said. “Since the morning after surgery, I have been pain-free.”

Today, Carolyn has returned to the wider world. She walks five miles a day and pursues many hobbies, including wildlife photography, memoir writing, cooking, crafts, volunteer work and caring for several pets. “There literally isn’t a morning that I wake up and I’m not grateful to Dr. Fanous and his team,” Carolyn said. “I remember what it was like before, and I credit him with the immense gift of mobility. It has given me a second life.”

Learn more about the Inova Spine Program at Inova Neurosciences, visit

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