I too would like to know why some get to be put under, and others just get local for pain injection also. Does anyone have information about this? Seanhorse, I didn't have health insurance eithor when I got my first spinal fusion. the doc. cut my costs as I asked him too. However, not every problem I had in my cervial spine was addressed or even told to me. I had problems that continued to degenerate as he only did what was necessary to keep me from being paralized. Evidently there was some risk concerning that. I got medicare, and then received my second fusion, where the whole of the neck degeneration was addressed. It is tuff without insurance. It took from me all that two generations had saved for. I do know what you are going through. I hope that a solution can be found to help your spine even though you do not have the insurance. ginnie