Todd Lanman, MD, is founder of Lanman Spinal Neurosurgery in Beverly Hills, Calif.
In 2017, he founded the Lanman Foundation for Spinal Advancement and Innovative Health, which focuses on advancing the science of spine health and provide surgical procedures for military veterans.
Here, Dr. Lanman discusses motion preservation research in spine, caring for military veterans and future goals of the Lanman Foundation.
Note: Responses are lightly edited for style and content
Q: What spine initiatives are the Lanman Foundation currently working on?
Dr. Todd Lanman: There are two main arms of the foundation. One is to provide advanced research about motion preservation and spinal surgery, which would evaluate off-label use of artificial discs and other motion sparing devices in the cervical and lumbar spine. The other is to provide benefit to patients directly because of limitations. I aim to provide state-of-the-art motion preserving surgery to our veterans that suffered injured necks or backs while on duty, including Special Forces, Navy Seals, Delta Force and Rangers. The foundation's funds will be used to provide implants and other devices needing to be placed inside the patient and cover the facility and anesthesia fees. I'll donate my surgical services and patients will be selected on a case-by-case basis.
Q: Can you tell us a little about your own experience undergoing spine surgery?
TL: I have three artificial discs in my low back. As of today, only one level is FDA-approved. I've got incredible pain relief having three discs implanted but insurance companies use the on-label FDA trials as their cut-off for what is considered experimental and what isn't. So, I want to provide a reservoir of outcome data for multilevel lumbar disc replacement, multilevel cervical and three- and four-level cervical disc replacement that demonstrates superiority of that modality over conventional fusion techniques or other motion limiting surgical techniques to promote functionality, range of motion and reduction of pain in the cervical neck or lumbar spine.
Q: What inspired your focus on U.S. military veterans? How will the Lanman Foundation provide care for veterans?
TL: I have some experience with friends that are 25-year veterans — Special Forces and Navy Seals — who have told me stories about how they and other active duty veterans, now retired, have severe spinal injuries. The Department of Veteran Affairs recommends spinal fusions. However, in my experience, most patients like these in their 30s and 40s, who remain active, would benefit from disc replacement surgery or other types of motion sparing surgeries. I would like to provide this surgery to injured Special Forces operatives and Seals, Delta Force and Ranger teams because they're put through a much more rigorous training program. I believe they'd likely face more high impact injuries related to their training and combat field experiences.
Q: What spinal research will you be conducting through the Lanman Foundation?
TL: I want to conduct multilevel artificial disc replacement studies, looking at three- or four-level artificial disc replacement in the neck, and comparing that to three- and four-level fusions and lumbar multilevel disc replacements. I also want to add certain hormonal and homeopathic supplements and research whether they provide improved bone healing and strength, while patients recover post-surgery. The stronger the patients are going into surgery, the better they are coming out. Will they benefit from some of these modalities before and after surgery? Perhaps we can get better outcomes and more rapid recoveries if we can supplement or treat them with different medications, hormones, homeopathic supplements and herbals.
Q: What was the motivation for creating the Lanman Foundation?
TL: I was motivated because of my frustrations in trying to get what I'm convinced are superior treatments for my patients approved by their insurance companies. Devices are approved by the FDA and the FDA states that once they approve a device, it is safe. We need to work to show that three- and four-level data driven outcomes show superiority or at least equivalency in outcomes to conventional spinal fusion treatments.
Spinal fusion treatments do reduce pain, but they severely restrict motion and that is not acceptable to many active people. Today as patients age, they want to maintain their functional and active lifestyles. They don't want to have multilevel fusions and be restricted in their ability to bend or pick up their children or grandkids. They want to travel and hike and be more active without restrictive motion. I'm driven to do this because of the limitations enforced by payers, when the hard evidence shows that these treatments are superior.
Q: How can people get involved with the foundation?
TL: It's going to take several million dollars to be able to do appropriate trials and studies and begin treatment for these protocols. For example, when we do trials with the FDA for new devices, most major device companies spend $50 million getting approval. It'll take several million dollars because of device purchases, facility costs and so forth to operate on patients that may need off-label treatments.
We'll start by implanting multilevel cervical and lumbar artificial discs in vets. By doing this, we'll be helping them and also provide a data pool showing that so we can kind of kill two birds with one stone.