I think the answer is:
If you know how to program and use Unity, it's not hard to use Spine's IK in Unity. If you're new to Unity or to programming in general, you may have a hard time, as you would doing many other things.
Spine-Unity already has some built-in solutions you can use to get results faster.
You also have the option of coming up with your own solution if you really wanted to, since the source code for Spine runtimes are readable and editable for your needs.
If you do get stuck somehow, you can always ask questions here in the forums.
Spine-Unity doesn't really work with Mechanim pre-Unity 5 because Spine doesn't use Unity's animation system (since Unity's system has limitations).
But Unity 5's Mechanim is more flexible. And when it comes out, Spine and Mechanim will be able work together, once their interface gets implemented.