[annapurna]

Some of your differences can come from what each surgeon has in their toolkit. The US doctor may not have anything to offer but fusion, which he knows isn't going to make everything better. India is, from a comment I heard here, somewhat conservative in the care they're willing to offer. Spain is probably less conservative but may not have the experience to offer two level on a regular basis. Germany has the experience and, depending upon which surgeon you're talking about, tends to be a bit sporty in what he's willing to do to resolve problems. To make it really interesting, do all four clinics/surgeons agree upon what your condition is?