The key to securing insurance approval is building a powerful, evidence-based case for medical necessity. This involves submitting extensive documentation from your healthcare team, including detailed letters from your surgeon and neurologist that explicitly link the surgery to your PPS and explain how it will improve your function, reduce pain, or prevent further disability. Supporting evidence like years of physical therapy records, imaging studies (X-rays, MRIs), and logs of failed conservative treatments (like bracing) is crucial to demonstrate that surgery is the only viable option, not an elective procedure. Being persistent and prepared to appeal a denial is often part of the process.