Bradford Curt, MD, is a board-certified neurosurgeon at Cincinnati-based Mayfield Brain & Spine specializing in spinal fusion, minimally invasive spine surgery and image-guided neurosurgery among others.
Dr. Curt provides his insight into the evolution of 3D printing in spine and the collaborative effort required to combat the opioid epidemic.
To participate in future Becker's Q&As, contact Alan Condon at acondon@beckershealthcare.com.
Question: How do you see 3D printing developing in spine?
Dr. Bradford Curt: 3D printing is an exciting and rapidly growing technology that is making an impact in several fields, from manufacturing to grade schools. As 3D printing expands further into healthcare, the expected impact in neurosurgery and spine surgery have already begun as an adjunct to performing safer and more effective treatments.
3D printing applications, also known as additive manufacturing and rapid prototyping, allow the creation of intraoperative guides for complex cases and personalized patient models for surgical planning. In the immediate future I see the expanding use of 3D printed models as a vital tool to aid in resident and fellow education as well as patient understanding of their condition and potential surgical treatment.
3D printing unlocks the ability to customize patient implants along with the standard pre-fabricated implant inventory. I foresee that the next expansion of 3D printing will be a more routine use in complex cases of deformity, tumor reconstruction and trauma reconstruction where personalized implants are superior to operating room carpentry. The hope is that this allows for safer and more effective surgical treatment with better outcomes.
I think future applications depend on overcoming current barriers. The time required to plan and create a 3D model, maintenance costs, accessory expenses of a 3D printer, and FDA approval are prohibitory for current routine spinal care. Advances in bioengineering will be required to hone materials that can perform like the human body. Despite the obstacles, I expect an expanding use of 3D printing technology as cost and production improves and material evolution progresses.
Q: Have you any thoughts on how to tackle the current opioid epidemic?
BC: The statistics examining the opioid epidemic serve to highlight the negative social and economic impact that opioid misuse and overdose has had on our country. Multiple factors have led to the current opioid crisis, and I believe tackling the current problem will require the cooperation of physicians, patients, companies, healthcare systems, government and the local community.
We physicians need to recognize and appropriately diagnosis a patient's underlying conditions, such as depression, which make pain management more complicated. Treating these pain-magnifying conditions will improve overall quality of care and pain management. Effectively identifying and treating the underlying cause of a patient's acute pain will shorten the need for pain management.
Patient education and a strong physician-patient relationship allow early communication of arising problems and possible medication abuse. Early detection and treatment will hopefully minimize abuse, dependence, and overdose risks. We need multidisciplinary approaches wherein a pain treatment team expands its focus on acute and chronic pain in a patient-centered fashion. Current systems have focused on the supply side aspect of the crisis by monitoring prescribing habits and reducing prescribed amounts.
The demand aspect of opioid misuse needs to be addressed as pharmaceutical companies innovate pain management options that include non-opioid as well as opioid medications and medications to combat opioid use disorder. As genetic testing improves, I hope to be able to choose more effective medications for individual patients while avoiding drugs that present more risk to the individual patient. Sole reliance on opioid pain medications must decrease as other less addictive or less easily abused options become available. Healthcare systems have and will need to continue to track medication usage and warn providers of possible abuse behaviors. These systems will need to connect our patients into an effective treatment and recovery program with local and government support.