Spine Surgery Second Opinion · Iowa Patients · Naples & Fort Myers FL
University of Iowa Hospitals
is excellent. It doesn’t offer
what we offer.
TOPS motion-preserving surgery. Lumbar disc replacement. Barricaid annular closure. Minimally invasive SI joint fusion. Corus MIS posterior fixation. PRP and BMAC biologics. No residents, no fellows — every surgery performed personally by Dr. Katsevman. Hundreds of five-star reviews across Google, Healthgrades, and WebMD. None of this is routinely available at UIHC, UnityPoint Health, or MercyOne. Telemedicine second opinion from Des Moines, Iowa City, Cedar Rapids, or anywhere in Iowa.
"University of Iowa Hospitals and Clinics is a genuinely excellent academic medical center — one of the finest in the Midwest. What it doesn’t offer is TOPS, lumbar disc replacement, Barricaid, MIS multilevel laminectomy, MIS SI joint fusion, or intraoperative PRP and BMAC biologics — and every surgery there involves residents and fellows. Hundreds of my five-star patients came to Naples after being told fusion was their only option. For many of them, it was not."
Dr. G. Katsevman, MD · Neurosurgeon & Spine SurgeonPatient reviews
Hundreds of five-star reviews —
from patients who were told fusion was their only option
Across Google, Healthgrades, and WebMD — three independent review platforms — Dr. Katsevman holds a consistently five-star rating with hundreds of verified patient reviews from across the US and internationally. Many came after being recommended fusion at UIHC, UnityPoint, or MercyOne and discovered all their options for the first time in Naples.
The most important step before spine surgery
A spine surgery second opinion
from a surgeon who offers what Iowa doesn’t
A second opinion is most valuable when the second surgeon can offer something the first cannot. Getting a second opinion within Iowa — UIHC, UnityPoint Health, MercyOne, or Genesis Health System — produces the same recommendation for the same reason: none of those surgeons are certified for TOPS or lumbar disc replacement, and none offer intraoperative PRP or BMAC biologics. The conversation here is different.
with Dr. Katsevman covers
Before your appointment, upload your MRI, X-rays, CT scans, and any operative reports from prior procedures. Dr. Katsevman reviews all imaging personally — not a coordinator, not a PA, the surgeon himself. The consultation addresses six specific questions that no Iowa academic program can currently answer for most patients:
Is the diagnosis correct?Many fusion recommendations follow accurate imaging but incomplete clinical correlation. A fresh review identifies whether the structural finding on MRI actually explains the symptoms — or whether something else, including SI joint dysfunction, is the real pain generator.
Are you a TOPS candidate?Grade I spondylolisthesis with stenosis — the most common diagnosis leading to a fusion recommendation — is exactly the indication for TOPS. 77% clinical success vs. 24% for fusion in the FDA RCT. Not offered at UIHC, UnityPoint, MercyOne, or Genesis.
Are you a disc replacement candidate?Cervical disc replacement: 5× lower reoperation rate vs. ACDF. Lumbar disc replacement (ProDisc-L®): more than 3× less adjacent degeneration vs. fusion. Neither is routinely offered at Iowa academic programs.
Does Barricaid apply to your discectomy?Barricaid closes the annular defect at surgery — reducing reherniation risk by 81%. Not standard at any Iowa academic program.
Is your laminectomy being approached optimally?Up to three levels of lumbar decompression through a single ~3 cm incision. Many Iowa academic programs still perform multilevel laminectomy open — often by residents in training.
Is posterior fixation being planned with MIS options?Patients recommended a “360-degree” cervical fusion may be candidates for Corus MIS posterior fixation instead — same stabilization through incisions roughly a quarter the size. Especially important for high-risk patients: osteoporosis, smokers, nicotine users.
The honest comparison
What Iowa spine programs offer —
and what they don’t
University of Iowa Hospitals and Clinics is the premier academic medical center in Iowa — a genuine research university hospital with strong specialty care. The gap is certification-based — not a reflection of quality, but of which technologies each program has chosen to pursue.
Univ. of Iowa (UIHC) · UnityPoint
MercyOne · Genesis Health
Strong standard spine surgeryUIHC produces solid outcomes for standard ACDF, lumbar fusion, discectomy, and laminectomy. It is the best academic option available in Iowa. The quality of care is not the issue.
TOPS not availableThe FDA Breakthrough Device for Grade I spondylolisthesis with stenosis — 77% vs. 24% over fusion in the FDA RCT — is not offered at UIHC, UnityPoint, MercyOne, or Genesis. Certification not pursued. Every spondylolisthesis patient is offered fusion.
Lumbar disc replacement not offeredProDisc-L® — more than 3× less adjacent degeneration vs. fusion — is not available at Iowa academic programs. Fusion is the default recommendation for lumbar disc disease statewide.
Barricaid not standard81% fewer reherniations after discectomy — not practiced at Iowa academic centers. The annular defect is left open after surgery.
PRP and BMAC biologics not offeredIntraoperative platelet-rich plasma and bone marrow aspirate concentrate are not available at Iowa academic spine programs as optional biological enhancements. Not part of the protocol.
Multilevel laminectomy often performed open — by residentsUIHC and other Iowa academic centers still frequently perform multilevel lumbar laminectomy through a large open midline incision. In teaching hospitals, residents perform significant portions of this surgery.
SI joint dysfunction — often missed or not treated surgicallyMany Iowa spine programs do not routinely diagnose or treat SI joint dysfunction surgically. Patients are misdiagnosed with lumbar disc disease and offered fusion for the wrong pain generator.
Open posterior fixation — no MIS alternativeWhen multilevel cervical fusion requires posterior stabilization, Iowa academic centers use traditional open posterior fixation. Corus MIS posterior fixation is not routinely offered.
Residents and fellows in every surgeryUIHC is a major teaching hospital. Residents and fellows perform portions of surgeries there. This is how surgeons are trained — but not what most patients assume when choosing the state’s flagship academic center.
This practice in Naples — what’s different
TOPS — official surgeon locator, one of few in the US77% vs. 24% over fusion in FDA RCT. Motion preserved. No cage, no bone graft. Same-day discharge. Not available at any Iowa academic center.
Lumbar AND cervical disc replacement — all three devicesSimplify®, ProDisc-C®, ProDisc-L®. Cervical: 5× lower reoperation rate. Lumbar: more than 3× less adjacent degeneration. Lumbar disc replacement is particularly rare at academic programs. Certified for all three.
Barricaid on every eligible discectomy81% fewer reherniations. Annular defect closed at surgery — standard here, not practiced at Iowa academic centers.
PRP and BMAC biologics — optional cash-pay, intraoperativePlatelet-rich plasma and bone marrow aspirate concentrate harvested during surgery and applied to the operative site. Optional cash-pay enhancements added on top of your insured surgery. Not offered at Iowa academic programs.
MIS multilevel laminectomy — up to 3 levels, ~3 cm incisionUp to three levels of lumbar decompression through a single small incision using the METRx tubular retractor. Muscles spread, not cut. Same-day discharge. Not the standard Iowa approach.
Minimally invasive SI joint fusion — accurately diagnosed and treatedSI joint dysfunction is frequently missed across Iowa. Dr. Katsevman accurately diagnoses it and treats it with percutaneous MIS fusion when conservative care fails. Same-day discharge.
Corus™ MIS posterior fixation — alternative to open rods and screwsQuarter-size incisions vs. open posterior surgery. Level I FUSE study evidence. Especially important for high-risk patients: osteoporosis, smokers, nicotine users. Not routinely offered at Iowa academic centers.
Dr. Katsevman performs every case personally — no residents, no fellowsNo exceptions. The surgeon who reviewed your imaging operates from first incision to closure.
Hundreds of five-star reviews — Google, Healthgrades, WebMDVerified, independent patient reviews across three platforms. Read them at floridaspinesurgeon.org/reviews.
The technology and biologics difference
What’s available here
that is not routinely offered at Iowa academic programs
77% vs 24% over fusion in FDA RCT. Grade I spondylolisthesis with stenosis. Stabilizes the slip. Preserves motion. No cage, no bone graft. Same-day discharge. Official TOPS surgeon locator — one of few certified surgeons in the US.
77% vs 24% · FDA RCTSimplify®, ProDisc-C®, ProDisc-L®. Cervical: 5× lower reoperation rate vs. ACDF. Lumbar: more than 3× less adjacent degeneration vs. fusion. Lumbar disc replacement is particularly rare — most Iowa programs have not certified surgeons for ProDisc-L®.
5× lower reoperation · FDA IDEAnnular closure device seals the disc defect at discectomy. 81% fewer reherniations in eligible patients. Recurrence is the most common reason for a second discectomy. Barricaid prevents it — not offered at Iowa academic centers.
81% fewer reherniationsDrawn from the patient’s own blood during surgery. Applied to the disc space, epidural space, or incision at the time of the procedure. Optional cash-pay biological enhancement — not available at Iowa academic spine programs. Surgery itself is billed through insurance.
Cash pay · autologousConcentrated bone marrow aspirate harvested during surgery and packed into the fusion cage. Optional cash-pay biological enhancement to support bone healing. Not available at Iowa academic spine programs. Surgery itself is billed through insurance.
Cash pay · autologousAt many Iowa academic centers, multilevel lumbar laminectomy is still performed through a large open midline incision — often by residents. Dr. Katsevman performs up to three-level lumbar decompression through a single ~3 cm incision using the METRx tubular retractor. Muscles spread, not cut. Same-day discharge.
Sacroiliac joint dysfunction is one of the most commonly missed diagnoses in spine care. Many Iowa academic programs do not recognize it as a surgical diagnosis. Patients are misdiagnosed with lumbar disc disease and offered fusion for the wrong pain generator. Percutaneous MIS fusion when appropriate. Same-day discharge.
Patients recommended “360-degree” cervical fusion may be candidates for Corus instead. Same stabilization through incisions roughly a quarter of the size. Far less muscle stripping. Especially valuable for high-risk patients: osteoporosis, smokers, nicotine users. Level I FUSE study evidence, published in Spine.
Level I · FUSE study · SpineRobotic guidance and intraoperative CT confirmation of every screw before closure. Continuous SSEP, MEP, and EMG neuromonitoring on every cervical, thoracic, and lumbar fusion — not universal even at major academic centers. EOS full-spine standing imaging for alignment planning under load. aprevo® custom 3D-printed interbody cages.
How it works for Iowa patients
Telemedicine second opinion —
then surgery if it makes sense
Upload your MRI, X-rays, and any prior specialist reports before the appointment. Dr. Katsevman reviews all imaging personally. The consultation covers your diagnosis and — specifically — whether TOPS, disc replacement, Barricaid, MIS laminectomy, MIS SI fusion, Corus, or PRP/BMAC biologics apply to your case. No travel required for this step.
Surgery is billed through your insurance in the standard way. Pre-operative requirements are coordinated — most completable in Iowa before you travel. If you choose to add PRP or BMAC biologics, those are priced separately as cash-pay additions and disclosed fully upfront. Surgery scheduled when it works for you.
Des Moines International (DSM) to RSW Fort Myers: approximately 2.5 hours direct on American and Southwest — multiple daily departures. Cedar Rapids (CID) connects via Chicago or Atlanta. The Quad Cities (MLI) and Sioux City (SUX) connect via Chicago. Iowa City residents typically drive 30 minutes to CID or 2 hours to DSM. RSW is 30 minutes from both offices. Most procedures: same-day discharge.
Post-operative follow-up by telemedicine from Iowa. Your Iowa physician receives a full operative report. If you have a Florida winter address or stay in Naples for the recovery period, you are recovering in Southwest Florida — not in an Iowa winter.
Questions from Iowa patients
What Iowa patients ask
before requesting a second opinion
UIHC recommended fusion for my spondylolisthesis. Is TOPS a real option? +
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. UIHC is a genuinely strong academic medical center. 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.
UnityPoint or MercyOne recommended ACDF for my neck. Should I consider disc replacement? +
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%). UnityPoint and MercyOne 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.
What are PRP and BMAC, and why are they cash pay? +
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.
Does my Iowa insurance cover surgery in Florida? +
Yes — most major Iowa insurance plans cover out-of-state surgery, including Wellmark Blue Cross Blue Shield of Iowa (the dominant Iowa insurer), Medica, UICI, 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. Wellmark BCBS of Iowa — which covers a majority of commercially insured Iowans — typically covers out-of-state care for services not locally available. PRP and BMAC biologics are the only cash-pay elements — optional add-ons priced and disclosed upfront.
If I get a second opinion at UnityPoint instead of UIHC, won’t I hear the same thing? +
Almost certainly yes. UIHC, UnityPoint Health, MercyOne, and Genesis Health System 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 Iowa academic and community spine landscape as a whole. The conversation changes when the second surgeon can offer what the first one could not.
I spend time in Southwest Florida during the winter. Can I time surgery during my stay? +
Yes — this is the ideal arrangement. Start with a telemedicine consultation from Iowa 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 Iowa. Des Moines to Naples is approximately 2.5 hours direct — a practical and comfortable trip. Iowa patients from Des Moines, Iowa City, Cedar Rapids, the Quad Cities, and Davenport find this arrangement well suited to their seasonal Florida travel patterns.
"Iowa patients come to me after being seen at UIHC — a genuinely strong academic center — told that fusion is their only option. The technology gap is not about institutional quality. UIHC is excellent. It simply hasn’t pursued the certifications for TOPS, lumbar disc replacement, Barricaid, or intraoperative biologics. That is the gap this consultation closes."
Gennadiy (Gene) A. Katsevman, MD
Neurosurgeon & Minimally Invasive Spine Surgeon · Naples & Fort Myers FL
★★★★★ Hundreds of five-star reviews — Google, Healthgrades, WebMD
Naples Top Doctor — Neurosurgery 2024, 2025, 2026
Official surgeon locator: TOPS™, Simplify®, ProDisc-C®, ProDisc-L®
Barricaid® on every eligible discectomy · 81% fewer reherniations
PRP & BMAC biologics — optional cash-pay, intraoperative, autologous
MIS multilevel laminectomy · MIS SI joint fusion · Corus™ MIS posterior fixation
aprevo® 3D-printed cages · EOS alignment · Robotic navigation · Intraoperative CT
Neuromonitoring on every cervical, thoracic, and lumbar fusion
No residents · No fellows · Dr. Katsevman performs every case personally
Fellowship — Barrow Neurological Institute under Dr. Juan Uribe
30+ peer-reviewed publications
Naples: 6101 Pine Ridge Road #101 · (239) 649-1662
Fort Myers: 8380 Riverwalk Park Blvd #320 · (239) 437-1121
Iowa Patients · Telemedicine Second Opinion · Hundreds of 5-Star Reviews · Naples FL
Before you commit to fusion
in Iowa — hear all the options.
Upload your MRI before the telemedicine appointment. Dr. Katsevman reviews everything personally. You will know whether TOPS, disc replacement, Barricaid, MIS laminectomy, SI joint fusion, Corus posterior fixation, or PRP and BMAC biologics apply to your case — and whether the 2.5-hour flight from Des Moines to Naples is worth making. Hundreds of five-star patients made that call. Most say they wish they had made it sooner.
6101 Pine Ridge Road #101, Naples, FL 34119
Fort Myers, FL 33919
Cedar Rapids, or anywhere in Iowa