Back pain breakthroughs

Dr. Hamid Abbasi is changing the standard of care when it comes to spinal fusion surgery. Abbasi is a neuro and spine surgeon at the Tristate Brain and Spine Institute in Alexandria. He's not only making a name for the center, he's also making Alexandria a global destination for breakthrough spinal procedures. At least that's on his agenda.

At the end of June, the first-ever Inspired Spine Education Conference, with cadaver labs, took place in Alexandria with neurosurgeons from around the world attending. The surgeons included Dr. Ralf Weigel from Germany, Dr. Noorludeen Jabbar from Dubai and Dr. Alvarado Morales and Dr. Tze Yeh from Costa Rica, along with one Minnesota surgeon, Dr. Lynn Miller from North Oaks.

The surgeons who came to Alexandria to take part in the conference, which he labeled as an advanced course, had to either be neurosurgeons or spine surgeons who have had experience with minimally invasive spinal surgeries.

During the three-day conference, the surgeons took part in a cadaver lab where they learned how to perform a new minimally invasive spinal surgery, Oblique Lateral Lumbar Interbody Fusion (OLLIF).

Dr. Abbasi has performed the OLLIF procedure nearly 400 times. He described it as an extremely technical surgery that is still fairly new. The concept of the procedure came to be in 2011, while the surgery itself wasn't performed until 2012.

"I was an early adapter of the surgery and started performing it in Alexandria in 2012," he said. "I have the highest reported number of cases and I am the only one who has published papers about this kind of procedure."

Traveling around the world, Dr. Abbasi presented his OLLIF surgery results to fellow spine and neurosurgeons at several different conferences. From there, many of the surgeons reached out to Dr. Abbasi for more information about the OLLIF surgery.

"They contacted me and asked me how they could learn this procedure," he explained. "There is nowhere on the planet you can go and learn about it extensively and effectively enough to nearly perform it yourself except in Alexandria, Minnesota."

After getting such keen interest, the spine center decided to host the conference.

Dr. Abbasi said OLLIF is not part of any residency program because it is still too new, but he's hopeful that one day it will be, so doctors can learn how to perform it and then it can become the new standard of care.

Prior to the OLLIF procedure, Dr. Abbasi explained there have been two other types of similar surgeries - the Posterior Lumbar Interbody Fusion (PLIF) and the Transforaminal Lumber Interbody Fusion (TLIF). PLIF surgery was first performed in the 1950s, explained Dr. Abbasi, who was disheartened to learn that many people are still performing this surgery.

"That was the standard of care 60 years ago and it is still being performed today," he said.

PLIF, even though it's still being performed, was surpassed by the newer TLIF, which was developed in the early 1980s.

"By all accounts, TLIF is the standard of care today," he said, adding, "but considering it was a procedure that was brought to the public more than 30 years ago, I am not so sure it should be anymore."

Dr. Abbasi said there have been other methods, but for the first time since the 1980s, there is enough clinical data to justify OLLIF as the new standard of care.

"And right here in Alexandria, we are making that standard of care for one of the most common problems in medicine - spinal issues," he said. "Almost every single adult will suffer back pain in their life."

Typically, when spine surgery is performed, the patient is "opened up" from the front and "filleted" just to get to the spine. With OLLIF, he said, "We go from the back and don't have to open up your abdomen to get there. We don't have to go through any vital structures from the front or back. This makes it way less painful for the patient."

Most often, after having the OLLIF procedure, there is little or no pain at all and the patient can walk home that day or the next day. A surgery that used to take roughly four hours now takes 40 minutes, he said.

"It's a new idea that you do a spinal surgery and the patient walks right after. That would be ridiculous a few years back," said Dr. Abbasi.

Now that the international surgeons have been to Alexandria and learned about the OLLIF procedure, they will be able to put it into practice. However, Dr. Abbasi said more than likely, they won't be performing it on their own right away. They will need additional support that will be provided by a team in Alexandria

Some of the doctors are hoping to partner with Dr. Abbasi again, along with a team from Douglas County Hospital. A surgical team from here, he said, would have to travel to Germany, for instance, to train the surgical team there. In addition, Dr. Abbasi would have to oversee the surgeon the first time he/she performs it.

Once they become proficient, he said they can then start doing it on their own. He stressed that patient safety is first.

"It's a very technical surgery. We are going to coach them very closely until we/they are comfortable," he said. "The amount of technology and intellectual knowledge that goes into doing this procedure is nothing short of going to the moon and back."

WHAT IS OLLIF?

Oblique Lateral Lumbar Interbody Fusion (OLLIF) is a minimally invasive interbody spine fusion. It is performed via multiple incisions, each about a half-inch long. It is done without cutting or separating muscle from bone, which makes recovery much quicker and puts patients back to regular life much faster than traditional open surgery.

BENEFITS OF OLLIF

A convenient, outpatient environment is often available, which means hospitalization may not be required.

Less blood loss than traditional methods is typical among patients because of smaller incision sites.

Less time spent in the operating room than traditional surgery, promoting faster recovery. Typically, an OLLIF procedure takes less than 90 minutes.

A minimally invasive and minimally disruptive experience, resulting in many patients finding they are able to get up, walk around and return home within a few hours of surgery. Typically, OLLIF patients return to normal recreational activities in a few weeks.