Todd Chapman, MD, is a fellowship-trained orthopedic surgeon at Charlotte, N.C.-based OrthoCarolina Spine Center, specializing in the treatment of spinal diseases of the cervical, thoracic and lumbar spine.
Dr. Chapman describes how he sees 3D printing developing in spine, the multifaceted approach to combating the opioid epidemic and more.
Note: Responses are lightly edited for length and clarity.
Question: What technology are you most excited about? Is there anything that you see as particularly innovative?
Dr. Todd Chapman: 3D printing technology has opened many doors in orthopedic surgery and particularly spine surgery. As we address and implement different technologies for specific pathologies in spine, 3D printing and patient specific technology allows us the potential to utilize implants with specific goals. We're looking at using it for restoration of alignment, preservation of anatomy, achieving specific surgical outcomes and more. With custom and patient-specific implants, we are able to better target our surgical goals. Having these tools at our fingertips and being on the forefront of using them in surgery carries significant potential to improve outcomes.
Q: Can you tell me about one operation that stands out in your career? What was particularly challenging and how did you overcome it?
TC: I am four years into my practice and have had several operations that stand out to me as challenging. Typically, the way I manage challenging surgeries is to anticipate them and know and rely on the resources around me. I have the benefit of excellent partners with a depth and breadth of experiences, more so than I do at this point in my career. Utilizing their expertise and thought processes has allowed me to overcome challenges by knowing what's ahead or having a thoughtful plan of how to address them when they arise. I also think that having a willingness to not only ask for, but also to accept advice and recommendations has helped me during those times.
Q: What do you consider when thinking about becoming an early adapter of a new device?
TC: When considering new devices I try to think about the potential challenges that adopting it into my practice may present down the road and weigh these against the proposed benefits. Most new devices are introduced and their benefits are touted, but rarely are the potential drawbacks or challenges discussed. As advocates for our patients, it is implicit on spine surgeons to assess each surgery and device to determine if the benefits are worth the potential risks.
As technological advances are introduced into the surgical arena, we are obligated to try to anticipate the risks that may arise and have a thoughtful plan of how to address them. I also fully believe that early adapters need to be clear and upfront with patients regarding the devices that are being utilized and the reasoning behind their introduction. There are potential improvements in care that occur with new technology but incorporating these in a prudent and thoughtful manner is paramount as we care for our patients.
Q: Have you any thoughts on how to tackle the current opioid epidemic?
TC: The current opioid epidemic is multifaceted in terms of reasons that it exists, and the approaches needed to address it should be multifaceted as well. Pain is certainly something that should be addressed, and narcotic addiction is a risk of opioid medication. Opioid use in our country is a profound problem and finding a balance is important. Some patients truly do benefit from the analgesic properties that allow them to live productive, meaningful lives. But because there is such a strong trend currently against narcotics, in the name of stemming the epidemic we also limit access for those patients who need them and use them appropriately.
Education and time spent with patients discussing expectations is a front line therapy that many of us as providers could dedicate more time to. Setting expectations that pain associated with surgery and orthopedic conditions is temporary is important. Utilizing other non-opioid medications to address the pain associated with injury and surgery is a parallel strategy we should continue exploring and implementing aggressively.
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