Spine Surgery Second Opinion · Massachusetts Patients · Naples & Fort Myers FL
MGH and Brigham and Women’s
are exceptional. They don’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 MGH, Brigham and Women’s, or Tufts Medical Center. Telemedicine second opinion from anywhere in Massachusetts.
"Massachusetts General Hospital and Brigham and Women’s are among the finest medical institutions in the world. I say this without reservation. What they don’t offer is TOPS, lumbar disc replacement, Barricaid, MIS multilevel laminectomy, MIS SI joint fusion, Corus posterior fixation, or intraoperative PRP and BMAC biologics. Hundreds of my five-star patients came to Naples after being told fusion was their only option. For many, 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 their local academic center and hearing all their options for the first time.
The most important step before spine surgery
A spine surgery second opinion
from a surgeon who offers what Boston doesn’t
A second opinion is most valuable when the second surgeon can offer something the first cannot. Getting a second opinion within Massachusetts — MGH, Brigham and Women’s, Tufts, Boston Medical Center, UMass Memorial — 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 Massachusetts academic programs typically cannot answer:
Is the diagnosis correct?Many fusion recommendations follow accurate imaging but incomplete clinical correlation. A fresh review by a surgeon with no stake in the prior recommendation identifies whether the structural MRI finding actually explains the symptoms — or whether something else (including SI joint dysfunction) is the actual 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 in Massachusetts.
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. Lumbar disc replacement in particular is rarely available at academic centers. Not offered in Massachusetts.
Does Barricaid apply to your discectomy?If a discectomy is recommended, Barricaid closes the annular defect at surgery — reducing reherniation risk by 81%. Not standard at any Massachusetts academic program.
Is your laminectomy being approached optimally?Up to three levels of lumbar decompression can be performed through a single ~3 cm incision using a minimally invasive tubular retractor. Many Massachusetts academic programs still perform multilevel laminectomy through a large open incision — often by residents in training.
Is posterior fixation being planned with MIS options?If you have been recommended a “360-degree” cervical fusion — ACDF plus open posterior rods and screws — Corus MIS posterior fixation achieves the same stabilization through incisions roughly a quarter the size. Particularly important for high-risk patients: osteoporosis, smokers, nicotine users.
The honest comparison
What Massachusetts spine programs offer —
and what they don’t
MGH, Brigham and Women’s, and Tufts Medical Center are world-class institutions. The gap is specific and certification-based — not a reflection of quality, but of which technologies each program has chosen to pursue.
MGH · Brigham and Women’s
Tufts · BMC · UMass Memorial
Excellent standard spine surgeryMGH and Brigham and Women’s are globally ranked academic programs. Standard ACDF, lumbar fusion, discectomy, and laminectomy outcomes are strong. The quality of care is not in question.
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 MGH, Brigham, or Tufts. The certification has not been pursued. Every spondylolisthesis patient is offered fusion.
Lumbar disc replacement not offeredProDisc-L® — which produces more than 3× less adjacent degeneration vs. fusion — is not available at Massachusetts academic centers. Fusion is the default recommendation for lumbar disc disease.
Barricaid not standard81% fewer reherniations after discectomy — not practiced at any Massachusetts academic center. The annular defect is left open after surgery.
PRP and BMAC biologics not offeredIntraoperative platelet-rich plasma and bone marrow aspirate concentrate are not offered at Massachusetts academic spine programs as optional biological enhancements. They are not part of the protocol.
Multilevel laminectomy often performed open — by residentsMany Massachusetts academic centers still 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 academic spine programs in Massachusetts do not routinely diagnose or treat SI joint dysfunction surgically. Patients with SI joint pain are frequently misdiagnosed with lumbar disc disease and offered lumbar fusion.
Open posterior fixation — no minimally invasive alternativeWhen multilevel cervical fusion requires posterior stabilization, Massachusetts academic centers perform traditional open posterior fixation — long midline incision, significant muscle stripping, rods and screws. Corus MIS posterior fixation is not routinely offered.
Residents and fellows in every surgeryMGH, Brigham and Women’s, and Tufts are teaching hospitals. Residents and fellows perform portions of surgeries at all of them. This is how surgeons are trained — but not what most patients assume when choosing a nationally ranked institution.
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 Massachusetts 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 in particular is rarely available at academic programs. Certified for all three.
Barricaid on every eligible discectomy81% fewer reherniations. Annular defect closed at surgery — standard here, not practiced at Massachusetts 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 academic programs in Massachusetts.
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 system. Muscles spread, not cut. Same-day discharge. Not the standard academic approach.
Minimally invasive SI joint fusion — accurately diagnosed and treatedSI joint dysfunction is frequently missed at academic programs. Dr. Katsevman accurately diagnoses it and — when conservative care fails — treats it with minimally invasive percutaneous fusion. Small lateral incision. Same-day discharge.
Corus™ MIS posterior fixation — alternative to open rods and screwsQuarter-size incisions vs. open posterior surgery. Far less muscle stripping. Level I FUSE study evidence. Especially important for high-risk patients: osteoporosis, smokers, nicotine users. Not routinely offered at academic centers.
Dr. Katsevman performs every case personally — no residents, no fellowsNo exceptions in any case. 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 Massachusetts 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 academic programs have not certified surgeons for ProDisc-L®.
5× lower reoperation · FDA IDEAnnular closure device seals the disc defect at the time of discectomy. 81% fewer reherniations in eligible patients. Recurrence is the most common reason for a second discectomy. Barricaid prevents it — not offered at Massachusetts 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 academic spine programs in Massachusetts. Surgery itself is billed through insurance.
Cash pay · autologousConcentrated bone marrow aspirate harvested from the patient during surgery and packed into the fusion cage. Optional cash-pay biological enhancement to support bone healing. Not available at Massachusetts academic spine programs. Surgery itself is billed through insurance.
Cash pay · autologousAt many Massachusetts 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 Massachusetts academic programs do not recognize it as a surgical diagnosis or have no pathway to treat it. 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 — ACDF plus open posterior fixation — may be candidates for Corus MIS posterior fixation 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 Massachusetts 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. Many Massachusetts patients discover options that were never presented at MGH or Brigham. No travel required for this step.
Surgery is billed through your insurance in the standard way. Pre-operative requirements are coordinated — most completable in Massachusetts 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.
Boston Logan (BOS) to RSW Fort Myers: approximately 3 hours direct on JetBlue, American, and Southwest — multiple daily departures. RSW is 30 minutes from both offices. In-person pre-op visit with Dr. Katsevman the day before or morning of surgery. Most procedures: same-day discharge.
Post-operative follow-up by telemedicine from Massachusetts. Your Massachusetts physician receives a full operative report. If you have a Florida winter address — Cape Cod is not the only option — recovery happens there. If you are flying home, most same-day discharge procedures allow return travel within days.
Questions from Massachusetts patients
What Massachusetts patients ask
before requesting a second opinion
MGH 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. MGH is one of the world’s great hospitals. TOPS is not offered there because the certification has not been pursued — not because the technology is experimental or unproven. A telemedicine second opinion determines whether your anatomy is a TOPS candidate before you commit to fusion that permanently eliminates motion at that level.
Brigham recommended ACDF for my neck. Should I consider disc replacement first? +
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%). Brigham and Women’s 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 for the procedure. 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 Massachusetts insurance cover surgery in Florida? +
Yes — most major Massachusetts insurance plans cover out-of-state surgery, including Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim, Tufts Health Plan, 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 that insurance does not cover, priced and disclosed upfront.
If I get a second opinion at another Boston hospital, won’t I hear the same thing? +
Almost certainly yes — which is precisely why a second opinion within the Boston academic system typically doesn’t change the outcome. MGH, Brigham and Women’s, Tufts, Boston Medical Center, and UMass Memorial 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 hospital-specific — it is a feature of the Massachusetts and broader Northeast academic spine landscape. The conversation changes when the second surgeon can offer what the first one couldn’t.
I have a place in Naples, Fort Myers, or on the Gulf Coast. Can I time surgery during my stay? +
Yes — this is the optimal arrangement. Start with a telemedicine consultation from Massachusetts 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 Massachusetts. Many Massachusetts patients — particularly from the South Shore, Cape Cod, the North Shore, and the western suburbs — spend meaningful time in Southwest Florida and find this a very practical arrangement. The surgery becomes part of the Florida stay rather than a separate trip.
"Massachusetts patients come to me after being seen at MGH or Brigham — institutions I respect enormously — told fusion is their only option. Many of them are TOPS candidates. Many qualify for disc replacement. The technologies exist. They are simply not available in Boston. That is the gap the telemedicine call is designed to close."
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
Massachusetts Patients · Telemedicine Second Opinion · Hundreds of 5-Star Reviews · Naples FL
Before you commit to fusion
in Boston — 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 3-hour flight to Naples is worth making. Hundreds of five-star patients made that call. Most say they wish they had called sooner.
6101 Pine Ridge Road #101, Naples, FL 34119
Fort Myers, FL 33919
Upload imaging before your appointment