By: 23 October 2018
Surgeon Focus – Todd Lanman

We speak to Todd Lanman, a spinal neurosurgeon and specialist in the advancement of spinal health and innovator in motion preservation surgery for more than 25 years. Todd is based in Beverly Hills and is the founder of Lanman Spinal Neurosurgery

In many ways, the spine is the root of one’s health. It can direct an individual’s entire quality of life, mobility and ultimately one’s level of happiness.

As world-renowned Beverly Hills spinal neurosurgeon and leading artificial disc replacement and motion preservation innovator Dr. Todd Lanman of Lanman Spinal Neurosurgery believes, without a healthy spine, there is no healthy life. As he decrees, movement is life.

Dr Lanman is a doctor who takes his own medicine. Following his own experiences undergoing a number of spinal surgeries himself, Dr Lanman combined this firsthand knowledge with his fundamental understanding of spinal health to devote his career to helping others to live pain-free lives and restore their mobility. As a specialist in the advancement of spinal health and spine surgery for more than 25 years, his attention to guaranteeing his patients the utmost in compassionate and skilled care under his watchful eye and steady hand has earned him top honours, his patients’ trust and respect, and recently in being named one of the Top Doctors in America.

In 2018, Southern California’s leading business publication, the Los Angeles Business Journal, recognised him for his nearly three decades of advancement in spine care and motion preservation, presenting him with the esteemed title of a ‘Leader in Health Care’ at their annual Health Care Leadership Forum and Awards.

As one of LA’s Top Doctors by The Hollywood Reporter and the Los Angeles Times, Dr Lanman is the go-to spinal neurosurgeon for many of Hollywood’s biggest stars, including A-list film and TV talent, legendary musicians, and other expert luminaries.

A Diplomate of the American Board of Neurological Surgery and a Fellow of the American College of Surgeons, Dr Lanman earned his MD at Chicago’s Northwestern University in 1983 with top honours and went on to complete his residency in Neurological Surgery at University of California at Los Angeles, under Drs W Eugene Stern and Donald Becker in 1989. Since then, he has led his spinal neurosurgery practice in the heart of Beverly Hills, which is affiliated with Cedars-Sinai Medical Center and UCLA Medical Center.

Dr Lanman has published nearly a dozen peer-reviewed articles, as well as authored chapters on topics relating to neurological surgery, and has presented more than two-dozen papers at national and regional medical society meetings. His expertise is sought out as he is often tapped to lead a wide swath of clinical trials for motion preserving surgeries and artificial disc replacement devices.

Most recently, Dr Lanman made history in the world of spine care advancement when he presided over the seven-year clinical trial for the newly FDA-approved two-level artificial cervical disc replacement procedure as its principal investigator, studying Medtronic’s Prestige LP device. He subsequently published the seven-year paper comparing cervical artificial disc replacement to fusion, and finding that the artificial disc replacement procedure in two adjacent cervical discs was statistically superior to that of fusion.

He has also remained an assistant clinical professor at UCLA for the past 20 years. As a media educator, Dr Lanman frequently appears on mainstream media outlets, such as CBS’ The Doctors and on network news stations in and around Los Angeles, to share with viewers ways in which they can protect their spines from injury, and leads the way in educating viewers about advances in spinal surgery, such as artificial disc replacement.

Through his proprietary 4D Health Process, Dr Lanman helps patients to think about their health in a more comprehensive and holistic way. He does this by going beyond the standard three-dimensional approach, incorporating all factors of one’s lifestyle to map out an entire preventative and forward-thinking approach to aging management, ensuring all of his patients live active healthy lives as they age. This includes several factors such as age, nutrition, hormone status, inflammatory and immune responses, exercise routine, and spine and joint health. By way of his meticulous analysis of each person’s body and lifestyle, he uses his decades of knowledge to shift the paradigm for how we view healthy living and aging through his new methodology.


SSN: As a specialist in spine surgery, could you tell us more about your experience and training background in this field?

TL: I have been board-certified in neurosurgery since 1993, and have been practicing since 1990, and the predominant portion of the last 28 years has been dedicated exclusively to the treatment of spinal disorders. My experience is really focused directly towards motion preservation surgery, predominantly artificial disc replacement, and currently facet replacement trials. Now that one and two level artificial disc replacements are Food and Drug Administration approved, we’ve expanded indications to include off-label use of three and four level disc replacements in the cervical spine, as well as the lumbar spine.


SSN: What drove you to choose surgery as a career – and spinal surgery in particular?

TL: I’ve always been mechanically inclined, and even as a child I loved to build models – the old plastic ones with glue – and would build submarines and all kinds of these devices, working in a three-dimensional space. I also became a mechanic, working my way through high school, college and medical school, and worked into auto body repair, rebuilt engines and straightened car frames and rebuilt fenders and so forth. And this was quite hands-on, and so it was a bit natural for me to proceed after medical school and have a career in surgery as I enjoy rebuilding and reconstructing – instead of automobiles, now with human beings in three dimensions.

Spinal surgery in particular is of great value in the sense of working in a three dimensional space and maintaining functionality and restoring motion and mobility, just as if one would restore the quality and speed of a car and its steering and handling abilities. Similarly, I like to keep motion, flexibility and handling ability of our spines to stay as active as possible as we age.


SSN: What’s the best part of your job?

TL: A happy patient. The best part is when you fix someone and they are so thrilled and so grateful to be out of pain and have restoration of motion. They can then do things again that they could not do before. That’s the most gratifying part of my job.


SSN: … and the worst?

TL: The worst part of my job is dealing with regulatory insurance companies for the most part who really try to disapprove almost anything that is considered off-label, and many patients really need an FDA off-label reconstruction in their spines. To explain that in detail is a bit tricky, but in general it is very restrictive for us to do everything on-label, and therefore would require us to do surgeries that are very restrictive with regards to the spine if we did everything on-label. So I simply consent the patients for an off-label indication and mix on and off-label surgeries together to create an active, functional patient with a best outcome. And I’ve found this to be very successful in the end.


SSN: What has been the highlight of your career so far?

TL: I think at this point the highlight of my career is being involved as a thought leader in motion preservation surgery and being an advocate for motion preservation artificial disc replacements, in particular. Patients have superior outcomes with more modern developed devices and diligently pursuing these devices, their functionality, their biomechanical features, we’ve been able to get great patient outcomes and derive superior benefits over the traditional methods of treatment so it’s been fun to be a leader in that world and an advocate for it.

SSN: Tell us more about the recent clinical trials you have been involved in as lead investigator?

TL: The most recent trial that I published was the two-level artificial disc replacement trial with the Prestige LP disc, which demonstrated superior outcomes in many outcome measures, particularly overall success, neck pain, arm pain, and neurologic functional success over fusion, with a third of the revision surgeries. These are the highlights of the most recent clinical trial. I believe there are going to be many new trials that will be coming soon with a variety of combinations of multi-level disc replacements, mixed with fusions and disc replacements, and other things that will further advance spinal surgical treatment.


SSN: How could this change the future of spinal surgery?

TL: It already is changing the future of spinal surgery. And it will continue to change it as it’s more adopted. There is some reluctance and some difficulties with health insurance approving discs and we see this because we know that patients travel to Germany, Spain, South Africa and Australia to get surgeries that they could easily get here if their insurance would simply cover these procedures that are rather commonplace everywhere else in the world but the United States.


SSN: If you weren’t a spine surgeon what would you be?

TL: My guess is I would be a fighter pilot, although I’m a little big to fit in the cockpit. What I was going to do if I didn’t get into medical school was to go to the Air Force Academy. I wanted to be a pilot. I wanted to be a fighter pilot. But being 6ft 4in and 225 pounds, I’m a little big for a fighter pilot cockpit. I did have the pleasure of flying an F-18 Hornet cockpit simulator and it’s a tight squeeze for a guy my size.


SSN: What would you tell your 21-year-old self?

TL: Eat better. And work out smarter. And don’t injure your spine or joints with foolish activities. Have more fun.


SSN: If you were Health Minister for the day what changes would you implement?

TL: I would reduce some of the restrictions and regulations that are currently present in the healthcare system. Of course, advocating safety and efficacy for patients, however I am confident there are many areas that could be adjusted to some extent while still maintaining excellent safety for the patients and providing them with many other successful options for outcome. This is in particular related to spinal conditions.


SSN: Away from the clinic and operating theatre – what do you do to relax?

TL: I really enjoy the beach. I enjoy being out on the water, whether on a jet ski or a surfboard, and I enjoy long-range target shooting, which is politically unpopular, but I’ll tell you it’s a lot of fun and I’ve been doing it since I’ve been a kid.


SSN: How do you think the future looks in the field of spine surgery?

TL: I think it’s very exciting, particularly with the motion preservation segment, as we’ve been discussing.