The 3R
Discectomy™

Remove — Minimally Invasive Tubular Discectomy

Traditional open discectomy requires cutting and retracting the large muscles of the back — causing significant tissue damage, more post-operative pain, and a longer recovery. Dr. Katsevman performs a fully minimally invasive discectomy through an 18mm METRx working channel, an incision smaller than a quarter.

The tube is dilated gently between muscle fibers rather than cutting through them, dramatically reducing trauma to surrounding tissue. A high-definition microscope gives Dr. Katsevman a magnified view of the nerve and disc fragment, which is then carefully removed to fully decompress the nerve root.

Patients walk the same day as surgery and go home the same day — no overnight stay. There are no activity restrictions at six weeks post-operatively.

Replace — Seal the Annular Defect with Barricaid®

When a disc herniates, it tears through the outer disc wall — the annulus fibrosus. After the herniated fragment is removed, this tear (the annular defect) remains open. If the hole is larger than a standard pencil-top eraser (~6mm), the reherniation risk rises significantly — and 73% of all disc reoperations come from patients with these larger annular defects.

When the defect meets clinical criteria, Dr. Katsevman implants the Barricaid® Annular Closure Device — an FDA PMA-approved, bone-anchored woven implant that permanently seals the defect through the same incision, creating a barrier that prevents additional disc material from reherniating. Barricaid does not restrict motion and is anchored only to one vertebral body.

Clinical evidence across 8 distinct study populations — including 2 randomized controlled trials and over 70 peer-reviewed papers — shows an 81% reduction in reoperations for reherniation versus discectomy alone. Over 11,000 patients have been implanted worldwide, with follow-up as long as 10+ years. 92% of Barricaid patients return to work within 90 days.

Not every patient qualifies. Eligibility is evaluated before surgery and confirmed intraoperatively. When indicated, it is one of the most impactful additions available — the goal is to make your first surgery your last.

Regenerate — PRP Biologic Therapy

At the conclusion of surgery, Dr. Katsevman can apply Platelet-Rich Plasma (PRP) — a concentration of your body's own healing growth factors prepared from a small blood draw before surgery. A small sample of blood is drawn, spun in a centrifuge to concentrate the platelets and anti-inflammatory proteins, and then delivered precisely where healing is needed most — while you are already in the operating room. No extra procedure. No extra appointment.

PRP is delivered to three targeted locations:

Into the epidural space — injected around the spinal nerves to reduce inflammation, relieving leg pain and back pain. Clinical data shows a 36% reduction in back pain at 12 months, with relief building gradually and continuing to improve — unlike steroids, which decline after one month.

Into the disc space (intradiscal) — injected directly into the degenerated disc to restore hydration, support structural repair, and reduce degeneration. At 6–12 months, MRI confirms improved disc hydration, reduced inflammation, and preserved disc height — structural repair, not just pain masking. Disc reherniation rate with PRP: 1.33% vs. 8.75% without PRP.

Into the surgical incision — applied at the wound site to accelerate tissue healing and reduce post-operative complications.

Results from peer-reviewed clinical research (2023–2026): 73% of patients achieved clinically meaningful disability improvement at 1 year. 91% were satisfied and would recommend PRP at 1 year. 50% of patients reduced their pain medication use. Zero major adverse events across all major clinical trials.

PRP comes entirely from your own blood — no synthetic additives, no risk of allergic reaction or rejection. Because it is currently off-label for spine surgery, PRP is typically not covered by insurance and is offered as a patient-elected add-on.