Your body’s own biology,
applied precisely
at the site of surgery.

The evidence depends heavily on the delivery method and the context. Standalone PRP injections for chronic low back pain have a mixed evidence base — some studies show benefit, others do not, and the results are highly variable by patient and condition. Intraoperative PRP applied directly to the surgical site during discectomy or decompression is a different clinical model. The biologic is delivered at a concentration and precision that injection cannot match, into a tissue environment (freshly decompressed, with active wound healing initiated) that is biologically primed to respond. The published literature on intraoperative PRP in discectomy shows promising effects on nerve root recovery, post-surgical pain, and annular healing — though long-term large randomized trial data continues to accumulate. Dr. Katsevman uses PRP intraoperatively as an evidence-informed adjunct to surgery, not as a standalone treatment.

PRP delivers concentrated growth factors from platelets — PDGF, TGF-β, VEGF, EGF, and IGF-1 — that stimulate tissue repair, reduce inflammation, and promote collagen synthesis. It does not contain cells capable of forming bone. BMAC delivers growth factors plus mesenchymal stem cells and osteoprogenitor cells that can differentiate into osteoblasts and directly form new bone. For procedures where the goal is tissue healing (discectomy, decompression), PRP is the appropriate biologic. For procedures where the goal is bone formation (spinal fusion), BMAC is appropriate because it contributes the cellular machinery for osteogenesis that PRP cannot provide. The selection is based on the biology of what each procedure requires, not on a preference for one product over the other.

The goal of intraoperative PRP and BMAC is to improve the quality of healing and potentially shift the trajectory of recovery in a favorable direction — not primarily to shorten the recovery timeline, though earlier and more complete healing can have that effect. Patients who receive PRP at the epidural space and disc space after discectomy may experience less post-operative inflammation and more effective nerve root recovery. Patients who receive BMAC in their fusion construct may achieve a more robust fusion. Neither biologic changes the fundamental recovery requirements of the procedure itself — activity restrictions, physical therapy milestones, and return-to-activity timelines are set by the procedure and the individual patient, not by the addition of biologics.

No — PRP and BMAC are not covered by insurance and are cash-pay add-ons to the surgical procedure. Neither biologic is reimbursed by Medicare, Medicaid, or commercial insurance plans when used as intraoperative adjuncts in spine surgery. The cost is separate from the surgical and facility fees, which are billed through insurance as normal. When Dr. Katsevman recommends PRP or BMAC for a specific procedure, the team discusses the cost transparently during surgical planning so there are no surprises. Patients who choose not to include PRP or BMAC do not affect the core surgical plan — they are adjuncts, not requirements.

This practice does not offer standalone PRP injections for back pain or neck pain outside of a surgical context. Dr. Katsevman is a spine surgeon — his practice is built around surgical evaluation and treatment. Patients seeking standalone PRP injections for chronic back pain, degenerative disc disease, or facet joint pain should work with a pain management or regenerative medicine specialist. If you have already pursued conservative care including PRP injections without satisfactory improvement and want to explore whether a surgical option applies to your case, a consultation with Dr. Katsevman is appropriate and telemedicine is available.

BMAC contains mesenchymal stem cells (MSCs) — multipotent progenitor cells capable of differentiating into bone, cartilage, fat, and other connective tissues. In that sense, BMAC is a form of autologous stem cell therapy. It is not the same as commercially marketed "stem cell injections" or embryonic/cord blood stem cell therapies. BMAC is derived from the patient's own bone marrow on the day of surgery — harvested intraoperatively from the vertebral body, ASIS, or PSIS while the patient is already under anesthesia — concentrated in the operating room, and applied immediately. It contains MSCs at concentrations found naturally in bone marrow — not artificially expanded cell populations. The bone-forming potential of BMAC comes from the osteoprogenitor cells within it, and that potential is most effectively utilized in the context of an active fusion procedure where bone formation is the goal and the biological environment is prepared to support it.