I am a bit puzzled by your statements about Medicaid, cheapest care, etc. I don’t know where you live and yes, you may not have the option of going anywhere you want, especially if your care is limited by the confines of an HMO or similar. But just because you have Medicaid does not automatically equate to a poor quality of surgical care. I worked as a hospital RN and just by general percentages, know that some of our patients were receiving disability, on Medicaid, Medicare, private insurance, HMO, PPO, etc. It still was the same surgeons doing the same surgeries, the same OR team, nurses postop, etc. Patients weren’t treated differently that any of us were made aware of. Nor did us staff have time to worry about who was paying for or covered by what! One of my nursing coworkers had 2 children with congenital disease who had extensive spinal surgeries; I know they were covered by SS Disability, etc. Perhaps I am not understanding your question/comments? I myself had a very unusual condition that needed to be fixed surgically (extensive surgery). Because my HMO could not provide what I needed, they were mandated to provide me with appropriate care by law. They weren’t happy about it. I had to keep pushing! But they did it!

Dr. Tom Jesson is a physician who decided to become a researcher on sciatica and cauda equina syndrome. He teaches physicians how to diagnose and treat patients with these conditions, and interpret MRI results like yours . I can't recommend highly enough.