Seriously here before I would consider any procedure from a Doc that has obviously left you in dire pain for so long believing ultram is a miracle drug I would do some frantic searching for another opinion myself.
You yourself stated "the pain never goes away" and you think this Doc has your best interests at heart?
Without knowing your medical coverage info I cant make any reccomendations on where to look but even without any coverage a good starting point would be a teaching hospital if nothing else. Most of those have some type of sliding scale fee or programs to assist.
I would be looking for better treatment options for my immediate pain issues before considering jumping thru anymore hoops and playing test dummy for a Doc who obviously has not cared enough to get me or keep me out of pain for so long.
My opinion here as I am a true believer that no one should have to suffer a pain that never goes away!
2 knee replacements & a hip.
spondylosis at L-4,5 & S1
arthritis,sciatica all that being a CPer entails!
If you stumble make it part of the dance!