Minimally Invasive Spine Surgery · Naples & Fort Myers, FL
Minimally Invasive
Laminectomy
Up to 3 levels of lumbar decompression through an incision smaller than a quarter. No fusion. No hardware. Spinous process and posterior ligaments left intact. Walk the same day. No restrictions at 6 weeks.
"The goal of decompression is to free the nerve — not to disrupt everything around it. The smaller the footprint of the surgery, the faster and more complete the recovery."
Dr. G. Katsevman, MD · Fellowship-Trained, Barrow Neurological Instituteto 3-level decompression
day of surgery
No bone graft
including return to sports
Who benefits
Are you a candidate for tubular laminectomy?
Minimally invasive laminectomy is designed for patients with lumbar spinal stenosis, spondylolisthesis, or neurogenic claudication causing leg pain, back pain, or difficulty walking — who want the nerves decompressed without fusion, without hardware, and without a large open incision.
Neurogenic Claudication
Leg pain, heaviness, or cramping that forces you to stop walking after a short distance — and gets better when you sit or bend forward. The classic presentation of lumbar spinal stenosis and the primary indication for laminectomy.
Spinal Stenosis
Narrowing of the spinal canal that compresses the nerve roots. Causes leg pain, numbness, tingling, and weakness — often bilateral. MRI-confirmed moderate to severe stenosis at one, two, or three levels is the anatomic target of this procedure.
Sciatica from Stenosis
Radiating leg pain caused by nerve compression in a narrowed canal. When the cause is stenosis rather than a disc herniation, laminectomy — not discectomy — is the correct decompressive procedure.
Spondylolisthesis Without Fusion
Many patients with Grade I spondylolisthesis and stenosis are told they need fusion. Dr. Katsevman frequently performs decompression alone — without fusion — when the slip is stable and symptoms are from nerve compression, not instability. No hardware, no bone graft, faster recovery.
Weakness or Foot Drop
Progressive leg weakness or difficulty lifting the foot (foot drop) indicates more advanced nerve compression. When weakness is present, timely decompression is important to prevent permanent neurological deficit. Dr. Katsevman prioritizes these cases.
Failed Conservative Treatment
Physical therapy, medications, and epidural steroid injections have not provided lasting relief — or symptoms are severe enough to justify moving directly to surgical evaluation. Most patients with stenosis benefit from at least 6 weeks of conservative care first.
The procedure
How minimally invasive tubular laminectomy works
Traditional open laminectomy requires a long incision and extensive stripping of the posterior back muscles. Dr. Katsevman’s approach uses the METRx 18mm tubular system to achieve the same or superior decompression through an incision smaller than a quarter — with a fraction of the tissue disruption.
Access through an 18mm tube — smaller than a quarter
Under general anesthesia, Dr. Katsevman makes a single skin incision in the lower back — typically under one centimeter, smaller than a standard pencil eraser. The METRx 18mm working tube is then dilated gently between the muscle fibers rather than cutting through them, creating a precise corridor to the lamina.
This is the critical difference from open surgery. Traditional laminectomy requires cutting and retracting the large erector spinae muscles along the entire length of the decompression, causing significant muscle injury, blood loss, and post-operative pain. The tubular approach displaces the muscle rather than destroying it. The muscle springs back when the tube is removed.
A high-definition surgical microscope provides Dr. Katsevman with a magnified, illuminated view of the surgical field — giving him the precision to work safely at every level required.
In select patients, Dr. Katsevman also employs an ultrasonic bone scalpel — a high-frequency ultrasonic instrument that cuts bone with exceptional precision while leaving soft tissue, nerves, and blood vessels unharmed. Unlike traditional rotating burrs or Kerrison rongeurs, the ultrasonic scalpel uses cavitation to sculpt bone without the heat or mechanical force that causes surrounding tissue damage. The result: less bleeding, more precise bone removal, and reduced trauma to the dura and nerve roots — particularly valuable in multi-level cases, revision surgery, or when the canal is significantly narrowed and the margin between bone and nerve is small.
Decompress the nerves — preserve what matters
Working through the tube, Dr. Katsevman removes the specific portions of the lamina and ligamentum flavum that are compressing the nerve roots — opening the spinal canal and relieving the pressure causing your pain, leg symptoms, and difficulty walking. Any bone spurs (osteophytes) or thickened ligament contributing to the stenosis are also addressed.
What stays intact — the tubular advantage
Unlike traditional open laminectomy, the tubular approach leaves critical posterior anatomy undisturbed:
Preserving these structures maintains the natural stability of the spine, reduces the risk of post-operative instability, and significantly decreases the need for fusion — even in patients with spondylolisthesis.
Up to 3 levels in a single surgery, through the same incision. Dr. Katsevman is the only surgeon in Naples performing multi-level tubular laminectomy — treating up to 3 contiguous lumbar levels simultaneously through a sub-quarter-inch incision, using a technique that redirects the working tube to address adjacent levels without additional skin cuts.
PRP Therapy — accelerating your recovery
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. Delivered while you are already in the operating room, PRP requires no extra procedure or appointment.
For laminectomy patients, PRP is applied to two targeted locations:
Into the epidural space — bathing the decompressed nerve roots in growth factors to reduce post-operative inflammation, accelerate nerve recovery, and improve residual leg pain relief.
Into the surgical incision — promoting soft-tissue healing, minimizing scar formation, and supporting a cleaner, faster wound recovery.
PRP is derived entirely from your own blood — no synthetic additives, essentially no allergy risk. It is currently off-label for spine surgery and is not covered by insurance; it is offered as a patient-elected add-on. Clinical data shows 36% back pain reduction at 12 months and 73% disability improvement with epidural PRP in lumbar spine patients. This is one more option that separates Dr. Katsevman’s approach from standard laminectomy care.
How it compares
Open laminectomy vs. tubular laminectomy
Both procedures decompress the nerves. The difference is everything that surrounds the decompression — and how fast you recover.
Open / Traditional Laminectomy
Long midline incision (4–6 inches)Requires exposing the entire surgical field through a large skin and muscle opening.
Extensive muscle strippingErector spinae muscles cut and retracted along the full length — significant injury, blood loss, and post-op pain.
Spinous process & ligaments removedPosterior tension band destroyed — increases risk of post-operative instability and the need for fusion.
Higher fusion rateRemoving posterior stabilizing structures often necessitates adding instrumented fusion — more hardware, longer surgery, longer recovery.
Longer hospital stay & recoveryTypically 1–3 night hospital admission. Activity restrictions extend for weeks to months.
No biologic augmentationStandard approach — no PRP or growth factor support for nerve or wound recovery.
Tubular Laminectomy · Dr. Katsevman
Single incision < ¼ inchUp to 3 levels decompressed through one sub-centimeter skin opening — hidden in the natural skin fold.
Muscle-sparing tube dilationMETRx tube dilates between muscle fibers — no cutting, far less blood loss, dramatically reduced post-op pain.
Spinous process & ligaments preservedPosterior tension band intact — spine remains naturally stable, reducing or eliminating the need for fusion.
Often avoids fusion — even with spondylolisthesisBy preserving posterior stability, Dr. Katsevman frequently performs decompression alone where others add fusion.
Walk same day · home same daySame-day discharge. No restrictions at 6 weeks — including return to professional sports.
Optional PRP biologic augmentationEpidural and incision PRP available for enhanced nerve recovery and healing — unique to Dr. Katsevman’s practice.
Common questions
What patients ask most
What is a laminectomy and why would I need one? +
A laminectomy is a surgical procedure that removes the lamina — the bony arch at the back of each vertebra — along with the thickened ligamentum flavum that is narrowing the spinal canal. This opens the canal and relieves pressure on the nerve roots. It is the definitive treatment for lumbar spinal stenosis, neurogenic claudication (leg pain with walking), and nerve compression from bone or ligament rather than from a disc herniation. When a disc is the primary cause, a discectomy may be more appropriate; Dr. Katsevman will determine the right approach from your MRI.
Why can Dr. Katsevman do laminectomy for spondylolisthesis without fusion when others recommend fusion? +
Many surgeons perform open laminectomy, which removes the spinous process, interspinous ligaments, and other posterior stabilizing structures. This destabilizes the spine and often necessitates adding a fusion to prevent the spondylolisthesis from worsening. Dr. Katsevman’s tubular technique preserves these structures entirely — the spinous process, supraspinous and interspinous ligaments, and the contralateral facet joint are all left intact. By maintaining the posterior tension band, the spine remains naturally stable even after decompression, making fusion unnecessary in many Grade I spondylolisthesis cases. This means no hardware, no bone graft, faster recovery, and lower long-term risks.
How can 3 levels be treated through one small incision? +
The METRx tubular system allows Dr. Katsevman to angle and direct the working tube to access adjacent spinal levels through the same skin opening. After decompressing one level, the tube is redirected slightly to reach the level above or below. This requires advanced technical expertise and precise familiarity with the tubular system — Dr. Katsevman is the only surgeon in Naples performing this technique at up to 3 levels. The result is a single incision smaller than a quarter, no additional skin cuts, and dramatically less tissue trauma than a standard multi-level open laminectomy.
What is neurogenic claudication and is it different from vascular claudication? +
Neurogenic claudication is leg pain, heaviness, cramping, or weakness caused by nerve compression in a narrowed spinal canal (spinal stenosis) — not by reduced blood flow. It classically worsens with walking or standing and improves with sitting, bending forward, or leaning over a shopping cart (the “shopping cart sign”). Vascular claudication, by contrast, is caused by arterial insufficiency, worsens with walking, and improves with standing still. The key distinguishing feature: if bending forward helps, it’s more likely neurogenic. An MRI and vascular assessment can confirm the diagnosis. Laminectomy treats neurogenic claudication; vascular surgery treats vascular claudication.
What is recovery like after minimally invasive laminectomy? +
Patients walk the same day as surgery and go home the same day — no overnight hospital stay. Most patients can return to desk work within 1–2 weeks. At six weeks post-operatively, there are no activity restrictions, including return to sports, exercise, and physically demanding work. The tubular approach causes dramatically less muscle trauma than open laminectomy, which is the primary driver of this rapid recovery. Optional PRP augmentation at the time of surgery can further accelerate nerve and wound healing for patients who elect it.
Will insurance cover minimally invasive laminectomy? +
Yes — laminectomy for spinal stenosis is covered by most major insurance plans when medically indicated. The minimally invasive technique is covered at the same rate as open laminectomy for the same indication. We work with all insurance plans, including out-of-network arrangements and GAP exception requests where applicable. PRP is off-label and typically not covered. Dr. Katsevman’s team will walk you through your specific coverage before any decisions are made.
Can I get a second opinion if I’ve been told I need open laminectomy or laminectomy with fusion? +
Absolutely — and for this procedure, a second opinion is especially worthwhile. Most surgeons performing laminectomy use open techniques that are significantly more disruptive. Many patients told they need fusion alongside their laminectomy are actually candidates for decompression alone when performed with the tubular approach. Dr. Katsevman offers in-person and telemedicine second-opinion consultations for patients across Florida and nationally. Bring your MRI and prior surgical recommendations — the difference in approach can change your entire recovery trajectory.
"Open laminectomy works. But when you can achieve the same decompression through a tube the size of a pencil — while leaving the spinous process, ligaments, and muscles intact — that is the better surgery for the patient."
Gennadiy (Gene) A. Katsevman, MD
Neurosurgeon & Minimally Invasive Spine Surgeon
The only surgeon in Naples, FL performing up to 3-level tubular laminectomy through a single quarter-inch incision
Fellowship-trained at Barrow Neurological Institute under Dr. Juan Uribe — world pioneer in minimally invasive spine surgery
Neurosurgery residency, West Virginia University — Level 1 Trauma Center
30+ peer-reviewed publications in spine surgery and neurosurgery
Routinely performs laminectomy for spondylolisthesis without fusion using the tubular technique
Naples Top Doctor in Neurosurgery — 2024, 2025, and 2026
5-star Google rating · Healthgrades Choice Provider · WebMD Preferred Provider
Offices in Naples and Fort Myers · Telemedicine available nationwide
Take the next step
Minimal disruption. Maximal results.
Schedule a consultation with Dr. Katsevman in Naples or Fort Myers — or via telemedicine — to review your imaging and find out if minimally invasive tubular laminectomy is right for you.
6101 Pine Ridge Road #101
Naples, FL 34119
Fort Myers, FL 33919
Available nationwide