Spine Surgery for UK & England Patients · Naples & Fort Myers FL · ~9 hours LHR→RSW direct
The NHS has made you wait long enough.
When surgery finally arrives,
it still won’t offer what we offer.
Over 6.25 million people on NHS waiting lists. Average 28 weeks for orthopaedic treatment — and that clock doesn’t even start until a consultant has seen you. When the NHS finally operates, TOPS, lumbar disc replacement, Barricaid, MIS multilevel laminectomy, and intraoperative PRP and BMAC biologics are not available anywhere on the NHS — or at Nuffield Health, Spire, or BUPA hospitals. Hundreds of five-star reviews. No residents, no juniors. Every surgery performed personally by Dr. Katsevman. Telemedicine consultation from anywhere in England.
"British patients come to me after months — sometimes years — on an NHS waiting list, or after being told by a private Nuffield or Spire consultant that fusion is their only option. TOPS, lumbar disc replacement, Barricaid, and intraoperative biologics are not available on the NHS or at any major private UK hospital group. The flight from London to Fort Myers is nine hours. The wait for NHS spine surgery is longer than that."
Dr. G. Katsevman, MD · Neurosurgeon & Spine SurgeonThe NHS waiting problem
Two problems with NHS spine care —
the wait, and what you get at the end of it
British patients face a two-stage problem. First they wait. Then, when surgery finally arrives — whether NHS or private — the technology available is the same limited set that was available a decade ago. The wait is one issue. The technology gap is another entirely.
The NHS spine pathway for most patients follows a staged referral process before the 18-week clock even begins. As of January 2025, approximately 6.25 million people were waiting for NHS elective treatment, with average orthopaedic waits running 28 weeks from referral to treatment — and that is only once a consultant referral has been made.
Going private with Nuffield Health, Spire Healthcare, or a BUPA-approved hospital removes the wait. It does not change the technology available. TOPS, lumbar disc replacement (ProDisc-L), Barricaid, and intraoperative PRP and BMAC biologics are not offered anywhere in the British private healthcare market at any significant scale. Private UK spine surgeons offer the same procedures as the NHS — faster, with a private room, but the same surgical options. If your condition is appropriate for TOPS or lumbar disc replacement, paying for private Nuffield or Spire surgery does not give you access to those technologies. They simply are not available in the UK.
Patient 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, including patients from the United Kingdom who came to Naples after exhausting NHS options or after being told that fusion was the only surgical choice available.
Before you accept fusion as the only option
A telemedicine consultation
with a surgeon who offers what the UK doesn’t
Whether you are on an NHS waiting list, have been seen by an NHS consultant, or have paid for a private Nuffield or Spire consultation, the surgical menu you have been offered is the same. A telemedicine consultation with Dr. Katsevman is the first step in hearing options that are simply not available in the United Kingdom.
with Dr. Katsevman covers
Before your appointment, upload your MRI, X-rays, CT scans, and any consultant letters or operative reports. Dr. Katsevman reviews all imaging personally — not a coordinator, not a junior, the surgeon himself. The consultation addresses six specific questions that no UK NHS trust or private hospital group can currently answer for most patients:
Is the diagnosis correct?An independent review by a surgeon with no stake in the previous recommendation 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 available anywhere in the UK.
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 in British private or NHS spine surgery.
Does Barricaid apply to your discectomy?Barricaid closes the annular defect at surgery — reducing reherniation risk by 81%. Not offered anywhere in UK spine care, NHS or private.
Is your laminectomy being approached optimally?Up to three levels of lumbar decompression through a single ~3 cm incision using MIS tubular retractor technique. Many UK surgeons — NHS and private — still perform multilevel laminectomy open. In NHS hospitals, trainees perform significant portions of this surgery.
Is posterior fixation being planned with MIS options?Patients recommended a combined ACDF and open posterior fixation may be candidates for Corus MIS posterior fixation instead — same stabilisation, incisions roughly a quarter the size. Especially important for high-risk patients: osteoporosis, smokers, nicotine users.
The honest comparison
What UK spine care offers —
NHS and private, the same technology limits
The NHS is a world-class institution for emergency and primary care. For elective spine surgery, it is constrained by both waiting times and the set of technologies it has adopted. Britain’s private hospital groups — Nuffield, Spire, BUPA — remove the wait. They do not change the surgical menu. The gap is not about clinical quality. It is about which technologies are practised.
NHS Trusts · Nuffield Health
Spire Healthcare · BUPA Hospitals
Competent standard spine surgeryACDF, lumbar fusion, discectomy, and laminectomy are performed competently across UK NHS trusts and private hospitals. For standard procedures, British spine care is sound. The issue is not quality — it is range.
TOPS not available anywhere in the UKThe FDA Breakthrough Device for Grade I spondylolisthesis with stenosis — 77% vs. 24% over fusion in the FDA RCT — is not available through the NHS or at Nuffield, Spire, or BUPA hospitals. It is simply not practised in British spine surgery.
Lumbar disc replacement not routinely offeredProDisc-L® — more than 3× less adjacent degeneration vs. fusion — is not routinely offered in UK spine surgery, NHS or private. Lumbar fusion is the default. Most British spine surgeons are not certified for ProDisc-L®.
Barricaid not offered in the UK81% fewer reherniations after discectomy — not available through any UK NHS trust or private hospital group. The annular defect is left open as standard UK practice.
PRP and BMAC biologics not offeredIntraoperative platelet-rich plasma and bone marrow aspirate concentrate are not available at NHS trusts or UK private hospitals as optional biological enhancements to spine surgery. Not part of UK practice.
Multilevel laminectomy typically performed open — NHS: by traineesOn the NHS, multilevel lumbar laminectomy is performed through a standard open midline incision, with trainees and registrars performing significant portions of the surgery. Even at private hospitals, MIS tubular retractor multilevel laminectomy is not standard practice.
SI joint dysfunction — frequently not recognised or treatedSI joint dysfunction is frequently missed in UK spine pathways. Patients with SI joint pain are often told they have lumbar disc disease and offered fusion for the wrong pain generator.
Corus MIS posterior fixation — not practised in the UKWhen combined anterior-posterior cervical fusion is required, UK surgeons use traditional open posterior fixation. Corus minimally invasive posterior fixation is not practised in British spine surgery.
NHS: trainees in every operation · Private: consultant-led but same technologyOn the NHS, registrars and foundation doctors participate in every elective operation. Private hospitals provide consultant-led surgery — but the technology available is identical to the NHS range.
This practice in Naples — what’s different
TOPS — official surgeon locator, not available in the UK77% vs. 24% over fusion in FDA RCT. Motion preserved. No cage, no bone graft. Same-day discharge. One of the few certified TOPS surgeons in the US. Not available anywhere in England, NHS or private.
Lumbar AND cervical disc replacement — all three devicesSimplify®, ProDisc-C®, ProDisc-L®. Cervical: 5× lower reoperation rate. Lumbar: more than 3× less adjacent degeneration. Certified for all three. Not routinely available in the UK.
Barricaid on every eligible discectomy81% fewer reherniations. Annular defect closed at surgery — standard here, not offered anywhere in the UK.
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 or self-pay surgery. Not offered in British spine surgery.
MIS multilevel laminectomy — up to 3 levels, ~3 cm incisionUp to three levels of lumbar decompression through a single small incision. Muscles spread, not cut. Same-day discharge. Not the standard approach in UK spine surgery, NHS or private.
Minimally invasive SI joint fusion — accurately diagnosed and treatedSI joint dysfunction is frequently missed in UK spine pathways. Dr. Katsevman accurately diagnoses and treats it with percutaneous MIS fusion when conservative care fails. Same-day discharge.
Corus™ MIS posterior fixation — alternative to open posterior rodsQuarter-size incisions vs. open posterior surgery. Level I FUSE study evidence, published in Spine. Especially important for high-risk patients: osteoporosis, smokers, nicotine users. Not practised in the UK.
Dr. Katsevman performs every case personally — no trainees, no juniorsNo registrars. No foundation doctors. No exceptions. The surgeon who reviewed your imaging performs every step, 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 difference
What’s available here
that is not available anywhere in the United Kingdom
77% vs 24% over fusion in FDA RCT. Grade I spondylolisthesis with stenosis. Stabilises the slip. Preserves motion. No cage, no bone graft. Same-day discharge. Official TOPS surgeon locator. Not practised anywhere in British spine surgery.
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 (ProDisc-L®) in particular is rarely performed in British spine surgery.
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 anywhere in UK NHS or private spine surgery.
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 in British spine surgery, NHS or private. Surgery itself is self-pay or insured in the standard way.
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 in British spine surgery. Surgery itself is self-pay or insured in the standard way.
Cash pay · autologousOn the NHS and in UK private hospitals, multilevel lumbar laminectomy is still performed through a standard open midline incision — on the NHS, with trainees performing significant portions. Dr. Katsevman performs up to three-level 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. The NHS MSK pathway is not well designed to identify SI joint dysfunction, and many patients are misdiagnosed with lumbar disc disease and placed on the surgical waiting list for the wrong pain generator. Percutaneous MIS fusion when appropriate. Same-day discharge.
Patients recommended combined anterior-posterior cervical fusion may be candidates for Corus MIS posterior fixation instead. Same stabilisation 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 standard in UK spine centres. EOS full-spine standing imaging for alignment planning. aprevo® custom 3D-printed interbody cages.
How it works for UK patients
Telemedicine consultation —
then travel to Naples if surgery makes sense
Upload your MRI, X-rays, and any NHS or private consultant letters and imaging 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. Technologies that are simply not available in the UK. No travel required for this step.
For UK patients travelling for surgery, the procedure is typically self-pay or covered through private international health insurance (BUPA International, AXA Health, Cigna Global, Allianz Care). Full transparent pricing provided before any commitment. Pre-operative requirements are coordinated — some tests completable in the UK before travel. If you choose to add PRP or BMAC biologics, those are priced and disclosed separately upfront.
London Heathrow (LHR) to RSW Fort Myers: approximately 9 hours direct on British Airways and American Airlines — the most direct UK-to-Southwest-Florida routing. Virgin Atlantic seasonal routes also operate. Manchester (MAN) connects via Atlanta or Heathrow. Edinburgh (EDI) and Birmingham (BHX) connect via Heathrow or US hubs. 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 telemedicine follow-up from the UK. A full operative report and discharge summary are provided for your GP and any UK specialists involved in ongoing care. Most same-day discharge procedures allow return travel within a few days. Many UK patients extend their Naples stay for a week or two — recovering on the Gulf Coast rather than returning to the UK in the immediate post-operative period.
Questions from UK patients
What UK patients ask
before travelling to Naples for spine surgery
I’ve been waiting over a year for NHS spine surgery. What are my options? +
You have two routes outside the NHS. The first is UK private surgery — Nuffield Health, Spire Healthcare, or a BUPA-approved hospital. This eliminates the wait entirely and provides consultant-led surgery within weeks. The limitation is that the surgical options available are identical to the NHS: standard fusion, standard discectomy, standard laminectomy. TOPS, lumbar disc replacement, and Barricaid are not offered in the UK private sector any more than on the NHS. The second route is travelling to Naples for a telemedicine consultation followed by surgery, where the full range of technologies — TOPS, disc replacement, Barricaid, MIS laminectomy, biologics — is available. The consultation is the first step and requires no travel commitment. Many UK patients who have gone private with Nuffield or Spire come to Naples after discovering that the technology gap persists even at private UK hospitals.
My NHS consultant recommended spinal fusion. Is TOPS available for my condition? +
If you have been told you need fusion for Grade I spondylolisthesis with stenosis — the most common diagnosis generating fusion recommendations — TOPS is a genuine alternative with substantially better outcomes data. The FDA randomised controlled trial showed 77% overall clinical success with TOPS versus 24% for fusion at two years. TOPS is not available in the United Kingdom — on the NHS or privately — because British spine surgeons have not pursued the certification. This is not a reflection on the quality of your NHS consultant. It is a reflection on which technologies the UK has chosen to adopt. A telemedicine consultation determines whether your specific anatomy makes you a TOPS candidate before you commit to fusion.
Will my private health insurance (BUPA, AXA PPP, Vitality) cover treatment in the USA? +
Standard UK domestic private health insurance policies — BUPA, AXA Health, Vitality, Aviva — typically do not cover planned elective treatment abroad. However, international private medical insurance policies — BUPA International, AXA Global Health, Cigna Global, Allianz Care, Healix — do cover treatment in the United States, including surgical procedures. If you have an international health insurance policy, coverage for elective spine surgery in Florida is likely available. If you hold a domestic UK policy only, treatment in Naples would typically be self-pay. Full transparent pricing is provided before any commitment, and the practice assists with insurance documentation where applicable. It is worth contacting your insurer directly before the consultation to understand your coverage.
I’ve already paid for a private consultation at Nuffield. Is travelling to Florida really worth it? +
That depends entirely on what your Nuffield consultant recommended. If the recommendation was standard lumbar fusion, ACDF, or discectomy, and your anatomy is appropriate for TOPS or lumbar disc replacement — technologies that are simply not available in the UK — then yes, the difference in long-term outcome may be very significant. Travelling to Naples for TOPS or lumbar disc replacement is not equivalent to medical tourism in the conventional sense. It is accessing a specific FDA-approved technology that is not available in your home country, performed by a certified specialist with hundreds of five-star reviews, with the full operative report provided to your UK GP. The flight is 9 hours. The NHS wait for the same standard fusion surgery Nuffield recommended is often longer than that.
What happens to my aftercare and follow-up when I return to the UK? +
A full operative report, discharge summary, and post-operative plan are provided before you fly home — formatted specifically for communication with your UK GP and any NHS or private specialists involved in your ongoing care. Post-operative follow-up appointments are conducted by telemedicine from the UK, at scheduled intervals aligned to the standard post-operative pathway. Your GP receives documentation describing the procedure, the implants used, and the follow-up requirements. Most UK GPs are well positioned to manage the general post-operative period with this documentation. For any imaging-based follow-up (X-rays, MRI), guidance is provided on what to request and when through your GP or private radiologist.
I’ve been diagnosed with lumbar disc disease and told I need fusion. Could disc replacement be appropriate? +
For single or two-level lumbar disc disease without significant instability, lumbar disc replacement (ProDisc-L®) is often the superior long-term option — preserving segmental motion and producing more than 3× less adjacent segment degeneration at 5 years versus fusion. For cervical disc disease, cervical disc replacement demonstrates a 5-fold lower reoperation rate versus ACDF at 5 years. Both procedures are rarely offered in the United Kingdom. British spine surgeons are not typically certified for ProDisc-L®, and the NICE guidance pathway defaults to fusion. A telemedicine consultation addresses whether your specific anatomy — disc height, endplate quality, alignment, adjacent segment status — makes you a disc replacement candidate before you commit to fusion.
"British patients who come to Naples have typically been through months on an NHS waiting list, or paid for a Nuffield or Spire consultation and been told fusion is the only option. The technology gap is not about the quality of British spine surgery — it is about which technologies have been adopted. TOPS, lumbar disc replacement, Barricaid, and intraoperative biologics are simply not available in the United Kingdom. That is a genuinely different conversation."
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 registrars · No juniors · 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
UK & England Patients · Telemedicine Consultation · Hundreds of 5-Star Reviews · Naples FL
You’ve waited long enough.
Find out if there’s a better option.
Upload your NHS or private imaging 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 9-hour flight to Naples is worth making. Hundreds of five-star patients from the US and internationally have made that call. Most say they wish they had made it sooner.
6101 Pine Ridge Road #101, Naples, FL 34119
Fort Myers, FL 33919
Upload NHS or private imaging before your appointment