IU Health and Franciscan
are excellent. They don’t offer
what we offer.

Yes — for Grade I spondylolisthesis with stenosis, which is the diagnosis that generates most spondylolisthesis fusion recommendations. TOPS stabilizes the vertebral slip while preserving controlled segmental motion. The FDA randomized controlled trial showed 77% overall clinical success with TOPS versus 24% for fusion at 2 years. IU Health is a solid institution. TOPS is not offered there because the certification has not been pursued — not because the technology is experimental. A telemedicine second opinion determines whether your anatomy is a TOPS candidate before you commit to fusion that permanently eliminates motion at that level.

For single or two-level cervical disc disease without significant instability — which describes most ACDF candidates — disc replacement is often the superior long-term option. The ProDisc-C FDA IDE trial demonstrated a 5-fold lower reoperation rate at 5 years versus ACDF (2.9% vs. 14.5%). Franciscan Health spine surgeons are not certified for Simplify® or ProDisc-C®. A second opinion from a surgeon certified for both — who will recommend whichever is better for your specific anatomy — is the right step before committing to ACDF.

PRP (platelet-rich plasma) is drawn from your own blood during surgery and applied to the disc space, epidural space, or operative site to support biological healing. BMAC (bone marrow aspirate concentrate) is harvested from your own bone marrow during surgery and packed into the fusion cage to augment bone growth. Both are autologous — from your own body, collected while you are already under anesthesia. They are cash-pay because insurance does not cover these biological add-ons. The surgery itself is billed to your insurance in the standard way. PRP and BMAC are optional enhancements, priced and disclosed in full before any commitment.

Yes — most major Indiana insurance plans cover out-of-state surgery, including Anthem BCBS of Indiana (the dominant insurer in the state), MDwise, CareSource Indiana, Aetna, Cigna, and UnitedHealthcare. The surgery itself is billed to your insurance in the standard way. The practice provides full documentation for out-of-state claims. PRP and BMAC biologics are the only cash-pay elements — optional add-ons priced and disclosed upfront. Anthem BCBS of Indiana in particular — the primary commercial insurer across the state — typically covers out-of-state care for services not locally available.

Almost certainly yes — which is exactly why a second opinion within Indiana’s healthcare system typically does not change the outcome. IU Health, Franciscan Health, Beacon Health System, Ascension St. Vincent, and Community Health Network all share the same structural limitation: their surgeons are not certified for TOPS or ProDisc-L®, and none offer intraoperative PRP or BMAC. The gap is not institution-specific — it is a feature of the Indiana academic spine landscape. The conversation changes when the second surgeon can offer what the first one could not.

Yes — and at roughly 2 hours direct from Indianapolis, Indiana is one of the closest Midwest states to Southwest Florida. This makes the snowbird arrangement particularly practical. Start with a telemedicine consultation from Indiana before your departure. If surgery is appropriate, it is scheduled during your Florida stay. Most procedures are same-day or next-day discharge. Recovery at your Southwest Florida address. Telemedicine follow-up after returning to Indiana. Many Indiana patients from Indianapolis, Carmel, Fishers, Fort Wayne, South Bend, and Evansville find this a very natural arrangement.