Spine surgeon built Burnsville campus to operate on patients others deemed too risky

Dr. Hamid Abbasi liked what he saw from the live X-ray images of his patient's lower back.

Six dark arrows on a monotone display revealed screws he drove into Tina Wallace's spine to boost its stability. Two blobs between them were spacers, designed for shock absorption, and they were surrounded by chemically enhanced bone marrow that was infused to repair spinal damage and reduce his patient's disabling pain.

"I'm calling it," Abbasi said to his team, ending the surgery. It had only taken 38 minutes.

"How many cc's?" he asked, referring to the amount of blood loss.

"Forty," said a nurse. That's barely enough to fill a shot glass.

Those are good numbers, and they are vital to Abbasi. The surgeon has built a mini-empire called Inspired Spine in Burnsville, a medical campus with its own clinic, surgery center, concierge hotel and affiliated factory that manufactures implants for Abbasi's minimally invasive surgeries. And it's all based on his confidence that he can eliminate back pain better and faster — and for patients who get rejected by other surgeons.

Abbasi has faced lawsuits and criticism that he is taking too many risks while trying to push his profession in a new direction. Fairview Health Services suspended his operating privileges at two of its hospitals last year, claiming he ignored colleagues' warnings and tried to operate on a patient with a risky history of blood clots.

Abbasi sued Fairview in response, arguing in an ongoing case that he is being targeted for retaliation because he blamed anesthesiologists for substandard postoperative care of a patient who died.

Good outcomes are the ultimate buffer against critics, so Abbasi tracks 48 measures of his surgical care, including operating time and blood loss. Over time, he hopes his data will convince colleagues to follow his lead and operate on older or obese patients who are written off as high-risk.

Denying surgery to obese patients is cruel because they can't lose weight while back pain limits their mobility, Abbasi said. "Lots of these people, they cannot walk, they have no life, they have lost jobs, lost relationships. They have nothing to live for, and they are told, 'You have to lose 100-200 pounds before we can do surgery.' ... And they can't!"

Inventing his own devices

Millions of Americans develop back pain, often when jellylike discs wear down and provide less padding and protection for the vertebrae in the spine. How to treat these patients is the conundrum.

Some gain relief through opioid painkillers, physical therapy, steroid injections or ablation procedures that blunt pain by burning nerve endings. Spinal fusions are promoted by surgeons such as Abbasi as durable solutions, implanting screws and cages that stabilize weak points in the spine and prevent them from causing pain by rubbing or pressing on nerves.

Trouble is, spinal fusions are expensive, sometimes risky and often overused. The Lown Institute last week reported that 14% of spinal fusions are performed in U.S. hospitals on patients whose back pain might be due to causes that the surgery can't fix.

Abbasi contends that fusions are underused on obese patients, because it takes surgeons too long with common techniques to cut through their larger anatomies and reach their spines. The delays increase risks of complications from surgery and side effects from anesthesia so much that doctors won't perform them. Placing patients on their stomachs can hasten access to their spines through their backs, but can put them at risk of respiratory complications by squishing their lungs.

Abbasi's surgical solution is the oblique lateral lumbar interbody fusion, or OLLIF, which accesses the spine through incisions about the diameter of a pencil, rather than open cuts. The doctor invented technology that hastens the procedure, placing patients on their stomachs and taking a diagonal route to the spine that threads between organs, muscles and bone. The result, he said, is that he can complete many fusions in less than an hour and reduce time-sensitive risks.

"The technology allows me to be where the problem is in minutes," he said.

Abbasi and a colleague reviewed 321 fusions performed at Fairview's Ridges Hospital in Burnsville and found the OLLIFs wrapped up one to two hours faster than the most common procedures, known as transforaminal lumbar interbody fusions, or TLIFs. The time gap was even wider when the surgeries involved obese patients, according to their study, which was published in 2018 in the open-access journal Cureus.

Dominick Taylor attempted to die by suicide when he lived in Maryland because he said he was stuck for years with overwhelming back pain and unable to lose weight. Surgeons refused to operate.

"People were like, 'You're just going to have to rethink how you deal with pain,'" he recalled. "That was really tough to hear over and over again. I mean, I was never out of shape until I couldn't move anymore."

The former football player at Crown College in St. Bonifacius returned with his wife and two children to Minnesota, where he said Abbasi's fusion relieved his pain and allowed him to drop from 365 pounds to 210.

Abbasi is listed by the U.S. Patent Office as the inventor of dozens of techniques and tools to aid in spinal surgery, including a tool kit that hastens OLLIFs. Some of his patented devices are manufactured by Advanced Research Medical, the affiliate of Inspired Spine on the same campus. Abbasi said he doesn't profit personally from ARM's sales, and that proceeds are reinvested in further research and device development.

Engineers often monitor Abbasi's surgeries so they can receive feedback and develop new or modified equipment. They have become adept at gaining quick clearance from the U.S. Food and Drug Administration for their innovations.

"If you do it the right way, actually, the government wants us to move fast," Abbasi said.

Dogged by lawsuits

Abbasi has been accused of moving too fast. A lawsuit alleged he performed an OLLIF in 2015 without explaining the risks to a patient who suffered "ongoing pain and disability" afterward. The case ended in a mistrial after Abbasi belatedly produced a consent form showing the patient had been warned, according to court records.

Inspired draws patients with TV ads, promoting OLLIF as a lower-risk solution to back pain that can take place same day at its outpatient center rather than a hospital. Abbasi talks up his approach as well on TikTok and other social media channels, but he said he takes precautions to reduce conflicts of interest because he does profit from each procedure.

A coordinator independently screens his patients to make sure surgeries are appropriate before they are scheduled.

Patients are steered to physical therapy, for example, if their pain is caused by vertebrae slipping out of place, Abbasi said. "Insurance companies let you do surgery for that without physical therapy. We don't."

In court filings, Fairview executives offered a different portrait of Abbasi as a risk-taker who received two warnings before his operating privileges were suspended at Ridges and the University of Minnesota Medical Center. Abbasi had tried to schedule an operation at both hospitals, but was blocked by anesthesiologists who felt he hadn't addressed the risks in a patient with a history of blood clots, records show.

A committee reviewing the suspension received more complaints, records show. One doctor told the group that he and colleagues had provided follow-up care to more than 100 of Abbasi's patients who endured complications.

Jen Sullivan, 47, said she was one of them. The Elk River woman said her scoliosis, or sideways curvature of her spine, worsened after Abbasi operated in fall 2020. She waited while Abbasi assured her she was healing, but said she shrank from 5-foot-5 to 4-10 by the time she received a corrective procedure at the U Medical Center.

"I physically couldn't stand up straight unless I bent my knees, and I had a hump on my back," she said, until after the follow-up surgery.

Fairview and Abbasi were sued last month by the family of another patient who died in May 2023 after back surgery at Ridges. Abbasi blamed the death on postoperative care by anesthesiologists at the hospital, and the wrongful-death lawsuit makes a similar accusation. The suit also questions why Fairview allowed the surgery if it had documented concerns about Abbasi.

Discrimination against obese patients

Abbasi called Fairview's claims "deeply harmful" and "false" and motivated by a competitor that is threatened by his success.

The dispute may restrict access for patients. Amber Konkler said Abbasi has encountered delays in scheduling operating time in a hospital and an anesthesiologist for her back surgery. The 49-year-old Hopkins woman is hoping for pain relief so she can visit Itasca State Park or simply lie on her floor and play with her pet rabbit.

Konkler said she felt discrimination because of her obesity in seeking treatments. One pain specialist ignored her concerns and showed her pictures of bread and salad and asked her which one was better.

"Dr. Abbasi, he is at least trying to combat that from the medical side," she said. "He fights for people like me."

Abbasi still operates in Alexandria, Minn., where he was previously based, and is licensed in 35 states. He recently trained doctors in India, where he said patients can't afford prolonged hospital stays and need access to same-day procedures such as OLLIF.

He added that he donated his patented designs to a university in India so manufacturers can produce low-cost tools for OLLIF surgeries in developing countries. He livestreamed Wallace's Oct. 24 surgery so doctors could learn from it.

Wallace suffered back pain and leg numbness after an injury in her family's furniture store in Culbertson, Mont. Other treatments didn't help, so she contacted Abbasi based on her chiropractor's recommendation and her own research.

The 53-year-old showered and dressed herself the day after surgery. A month later, she is celebrating her renewed mobility, but lamenting the time she spent in pain, missing her daughter's high school and sporting events.

"I feel like I lost two years of my life with this," she said.