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Inside the Transition Zone where we spend TIME discovering.

May 18,2018
This is where back and neck pain is the most important thing on my mind.   There's an old joke about a patient who says, "Hey doc, it hurts when I do this." Without even bothering to look up, the doctor replies, "Then don't do that." Of course, this cynical view of the doctor-patient relationship is hardly the reality. MOST doctors look. But here’s the problem – for quite a…
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Spine Health in the Transition Zone: Preserving motion should be your most important goal.

May 04,2018
Why let pain drive you to desperate solutions that ultimately places you into the “fusion box”?   Konrad Bright lives an active life on the North Shore of Oahu, Hawaii. He’s been surfing all his life and is training in the martial arts. But one day, something went wrong. While enjoying one of those idyllic surfing days on the beach, excruciating pain shot through his lower back.   He initially believed…
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Live in the transition zone and preserve motion

April 20,2018
All around the web, you’ll find information about how surgeons can fix your neck or back pain with minimally invasive techniques. Some procedures are performed on an outpatient basis. You can literally be cured of a chronic spine disorder and be out of the office in a matter of hours and ready to go back to a painless life. But it’s not always that simple, and surgery is not always…
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A Full and Fulfilling Life – without the Fear

April 06,2018
How to keep your freedom of movement AND solve your chronic neck and back pain. Pain is a natural part of life, but especially as we age. Now that we are living longer and, as we age, we tend to want to stay active as long as possible, pain is all but inevitable. Chances are much higher that we will encounter some situation – some injury of some kind -…
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Exercises and lifestyle choices to avoid back and neck surgery

March 23,2018
There are several exercises that you can do to help you avoid back and neck surgery. But there are also important lifestyle choices that I recommend you consider. Exercises and lifestyle choices are always essential elements in everything we do. I’ve been a spinal neurosurgeon for over 20 years at Cedars Sinai Medical Center in Los Angeles. I’m also a professor at the UCLA Medical Center. I’ve also led several…
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Failed Back Surgery Syndrome (FBSS): How a good doctor and patient relationship can avoid a syndrome.

March 16,2018
A friend of mine who keeps track of all things Internet told me this statistic which I thought was pretty significant. About 85% of Americans use the web to investigate the status of their health.  I have said before that I applaud this trend, and I hope it only grows stronger. I say this because in my 25 years as a neurosurgeon – and from the perspective of my private…
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Failed Back Surgery Syndrome (FBSS): Why patients should question this “diagnosis.”

March 03,2018
Failed Back Surgery Syndrome – otherwise known as FBSS – is not a real diagnosis. While I’ve met patients that have been given this “diagnosis” by other physicians and appreciate their genuine pain, the cause of the condition is too broadly defined.   When I went to medical school, one of the first things I learned was that every word has meaning. The word “diagnosis” connotes a process whereby a…
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What is Failed back surgery syndrome?

February 16,2018
Failed back surgery syndrome is a condition associated post-operatively with back surgeries. It is a diagnosis given to patients who have continued pain after back surgery. Also known as failed back syndrome on the web, it is typically associated with chronic and persistent pain at or near the surgery location.   In my opinion, the label "syndrome" is misplaced. Purely from a clinical standpoint, post-operative pain is not linked –…
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How long will it take to recover from back surgery?

February 02,2018
Recovery from the four principal types of back surgery - laminectomy, discectomy, spinal fusion, and artificial disc replacement – will vary because each surgical procedure affects the body in different ways. Recovery from these surgical procedures also depends significantly on the extent of damage from spinal conditions such as degenerative disc disease, spinal stenosis, spondylolisthesis, and other disorders of the spine.   Post-Operative Recovery from Back Surgery   Age and…
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What are the different types of back surgery?

January 13,2018
  Laminectomy, discectomy, spinal fusion, and artificial disc replacement are the four principal types of back surgery to treat conditions such as degenerative disc disease, spinal stenosis, spondylolisthesis, and other disorders of the spine.     Laminectomy   Laminectomy is often recommended for patients suffering from spinal stenosis, or a progressive narrowing of the nerve channels (the foramen) within the vertebral bone. The "narrowing" is caused by abnormal bone growth…
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Why is Artificial Disc Replacement surgery better than Spinal Fusion?

December 29,2017
  Only artificial disc replacement offers the promise of preservation of the natural range of motion of the spine. Fusion, by its very nature, cannot do this. Artificial discs replace damaged discs, thus allowing the vertebrae to function as close to normal as possible. Fusion requires that at least two vertebrae bones are fused together - permanently. The pain is gone (or reduced), but the cost is a noticeable reduction…
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What is spinal surgery?

December 16,2017
Spinal surgery is a class of surgical procedures that are used to treat patients with spine conditions such as degenerative disc disease, isthmic spondylolisthesis, degenerative spondylolisthesis, and other disorders of the spine. There are four principle types of spinal surgery: laminectomy, discectomy, spinal fusion, and artificial disc replacement. The specific procedure that a physician will prescribe depends on the diagnosis. When degenerative disc disease is diagnosed, the physician will look…
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Doctor’s Journey: Recovery

November 24,2017
As a patient going through recovery, I realized the importance of having a PLAN. There are some things that doctors just can't learn in medical school. Bedside manner is one of them. You can only learn how to talk to patients through the experience of treating them. But what is it like to experience surgery – first hand? What's it like to experience postoperative recovery?   That's one of the…
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Doctor’s Journey: Postoperative Healing

November 13,2017
Lessons I learned as a patient going through postoperative recovery from back surgery.   Many of my patients take some comfort in knowing that, as their surgeon, I have also undergone the very procedures I prescribe for them. From the patient's point of view, it makes total sense. Having been a patient, and being a patient now, I have insights on procedures and processes that many other surgeons find are…
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Doctor’s Journey: The Ultimate Patient Experience

October 13,2017
What being my own patient taught me about treating back and neck pain.    When I was in high school, I was a swimmer. I enjoyed working out in the pools and in the master swim programs, I loved the competition, the team experience, and the workout. To augment my performance, I engaged some light weight training and occasional elliptical and cardiovascular exercises to augment my endurance.   Inevitably, there…
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Don’t Settle for a Life with Pain

September 22,2017
Artificial Disc Replacement can help us reach for the highest quality life possible – no matter how old we are.   As we age, we develop pain. It’s a natural process of aging, but also life. Add the fact that we are living longer (much longer than our parent’s generation) only increases the likelihood that we will develop chronic neck and back pain.   That doesn’t necessarily mean that we…
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Artificial Disc Replacement as an Alternative for Failed Spinal Fusion

September 09,2017
Revision strategies for patients with prior cervical fusion   Spinal fusion has a long history. The procedure itself was developed over time from the early 1900s as a means of limiting spinal deformity caused by infections of tuberculosis. It was actually a coincidence that surgeons later realized that the procedure was also useful for patients who suffered from chronic pain in the lower back (lumbar) region.   Throughout the 20th…
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Artificial Disc Replacement Revisions for Patients with Prior Neck Fusions

August 25,2017
Changing the course of patient outcomes with Artificial Disc Replacement surgery.   One of my patients is an avid golfer who had three disks in her neck fused. It had been several years since her last surgery, and she was developing new pain in her neck. Not only were the fusions limiting the range of motion of her spine, but persistent pressure on adjacent levels had also degenerated the disc…
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Review Your Treatment Options for Neck and Back Pain.

August 02,2017
Know the facts: Spinal Fusion versus Artificial Disc Replacement?   A neurosurgeon has already diagnosed you with degenerative disc disease resulting from a "slipped" or a herniated (ruptured) disc. You don't remember how you got your injury - it could have started from any impact you received 20 years ago or an accident you had a year ago. Either way, you suffer from chronic neck or back pain (or both),…
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Artificial Disc Replacement: Why it’s better.

July 28,2017
ADR is no longer an alternative; it's the clearly the solution.   I see a lot of patients from all walks of life. Some of them are actors and professional athletes; some are business executives and entrepreneurs; most are average people of all ages that have neck and back pain issues that are so severe that they need medical help. That’s when I get to work with solutions so that…
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Are you a victim of “Text Neck”?

July 14,2017
At least now you have better surgical choices when you need corrective surgery.   Prepare for shocking headlines: habitual cell phone use can lead to a higher risk of spinal damage that may increase your chances for surgery later in life. Do you think I'm overly dramatic?   Think of all the things we do with our "phones" nowadays. Now think about who has one of these devices: kids as…
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Artificial Disc Replacement is more than just another surgical procedure.

June 23,2017
Finally, we can say that there is a viable alternative for spinal fusion.   When it comes to neck and back pain, it is often a cause and effect' process: one thing always leads to another. “Discs" are semi-soft complex structures that cushion the individual bones (vertebra) of the spine. The outer layer of the disc consists of a cartilage-like tissue that gives the disc some rigidity. The inner portion…
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Artificial Disc Replacement Surgery

June 09,2017
Why ADR is a “page-turning” medical development that ALL patients should know about. I see patients, every day, who are broken by excruciating, often debilitating pain. I'm kept very busy by a nearly non-stop schedule at my private practice in Beverly Hills and in my work as an associate surgeon at Cedars-Sinai Medical Center in Los Angeles.   When I meet my patients for the first time, many will peer…
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4D Health Process: DISEASE SCREENING

May 26,2017
How “asymptomatic” disease screening is the best medicine you can take.   When we think of modern medical innovations, it’s easy to think of “Eureka moments” that not only conquers disease but also increases our quality of life. The microscope allowed us to see bacteria for the first time. Penicillin gave us a sure cure for infections. Vaccinations of all kinds allow us to inoculate whole populations from hundreds of…
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4D Health Process: CHEMICAL BALANCE

May 12,2017
How you can get your balance back with supplements and hormones.   When you think of the word “wellness,” do you think “fitness”? “Nutrition”? “Disease screening”? How about, “chemical balance”?   Of all the ‘dimensions’ in the 4D Health Process, chemical balance is the one that’s the hardest to understand, but once you are aware, it’s impossible to ignore. I am, of course, talking about chemical balance through hormone maintenance…
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4D Health Process: FITNESS

April 28,2017
Want a healthier spine? Work on your musculoskeletal system and EXERCISE!     We should think of the human body as a collection of systems: groups of organs and tissues working together to help the entire body function. I’m particularly familiar with the musculoskeletal system. This one is a little unique because it fills so many functions. Composed of our bones, muscles and a variety of connective tissues it is…
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Don’t just sit there! MOVE!

April 14,2017
Relieve common causes of back and neck pain. NINE easy exercise routines that you can do anywhere – even while sitting.   Exercise should be as much a way of life as eating and drinking. Exercise will make you stronger, more energetic, and more alert. I have seen clear evidence of how physical activity has helped patients who suffer from common neck and back pain. This may seem counterintuitive if…
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4D Health Process: NUTRITION

March 31,2017
The simple long-term solution for neck and back pain – is a lot simpler than you think! As a neurosurgeon at my practice in Beverly Hills and an associate surgeon at Cedar-Sinai Medical Center in Los Angeles, I specialize in treating patients who suffer from back and neck injuries and disease. Often, the treatments lead to spinal surgery with artificial disc replacement and spinal fusion among the most common outcomes.…
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Sitting Around and Waiting for Trouble

March 17,2017
Sitting around too much puts you at risk for back and neck pain.     Sitting down and resting your weary bones feels wonderful. Sitting for brief periods of time is natural and necessary. You're probably doing it now, at your desk, whether you are having a quick snack or cup of coffee, or working, or winding away the hours on social media.   Ironically, not only do I see…
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Spine Health: Can bad posture injure your spine?

March 03,2017
How have habitual hunching and slouching increased your chances of a herniated disc?   As it turns out, we have learned good health lessons from some of the oldest aphorisms. Science has confirmed that eating an apple a day really does have some excellent health benefits. Who can argue that an ounce of prevention is WAY better than a pound of cure? And who would have guessed that laughing is…
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Consequences of Living Longer

February 17,2017
A “4D” approach: Be Greater than Better   The good news is that we’re all living longer. The bad news is that most adults don’t know how to live longer.   Advancements in medical technology is largely responsible for longer lifespans – we can cure more, heal faster, and even replace organs and limbs that are broken in the process.   From my work at my practice and as an…
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Recovering from a Spinal Surgical Procedure?

February 03,2017
Your recovery is a partnership to grow strength and preserve movement.   “A stitch in time saves nine.”   That’s what my grandmother used to say. You can take that to mean that acting promptly in the short term saves effort in the long run. You can also apply it to the idea that it is always better to be prepared with information and insight. My granny might add, “Being…
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Cyclists Neck: Persistent Pain After a Ride?

January 20,2017
Love the sport, but pay attention to the details and save yourself from injury. I mentioned a friend of mine in an earlier post who is an avid cyclist. When we met, he had just walked off his fourth ‘century’ ride – a hundred miles on a bicycle. I have a lot of respect for all athletes. Anyone who can stick to a workout program and do something like that…
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Diets that Help with Post-Operative Healing

January 06,2017
Foods that can Help You heal after Back Surgery “We are what we eat,” as my good friend and colleague Dr. Philip Goglia says. Philip is a certified nutritionist. He has more than 30 years of experience – helping and healing through nutrition.   The fact is, he has helped many of my patients during postoperative recovery with his peerless knowledge of performance nutrition. When Philip tells me about the…
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No Quick Answers for Back and Neck Pain

December 23,2016
It’s time to take time and get to know your options.    Some people are in such a hurry that they want simple answers for everything. When it concerns the pain in your neck or back, it’s time to take time and really get to know your options.   The first and most important point: surgery is not always the first and final answer. I have many friends and patients…
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An Overview of Common Spinal Surgical Procedures

December 09,2016
A general guide for online researchers.   These descriptions are based on frequently asked questions from my patients. I give these summaries to help patients understand the procedures I am prescribing. Use these descriptions as a guide for your own path back to wellness. Remember that the term “cervical” refers to the neck area, “thoracic” refers to the center core of the body, and “lumbar” refers to the lower back.…
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No Diets – Just Lean Living

November 25,2016
Tips for Lean Living, Foods that Help You Burn Fat, Not Muscle   I’m always talking up the importance of spine health. But there’s also the whole body health that goes hand in hand with everything else. My good friend Dr. Philip Goglia - a certified nutritionist for more than 30 years – has helped many of my patients with his expert knowledge of elite performance nutrition and rejuvenative health.…
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Is Disc Replacement Surgery Right For You?

November 11,2016
Who is the ideal candidate for anterior cervical disk replacement surgery?   More than ten years ago, when I was a clinical investigator in the early medical trials for artificial replacement discs, the FDA approved the first set of rules for physicians on the selection criteria for patients. To be perfectly honest, there were no surprises: the FDA included people who experience chronic neck pain and arm pain from diagnosed…
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Artificial Disc Replacement versus Spinal Fusion

October 28,2016
Which spinal surgical procedure is right for you? The big difference between artificial disc replacement surgery and spinal fusion surgery is dependent on the severity of the case I’m treating. Either procedure may apply for cervical, or lumbar regions of your back (neck, lower back, respectively).   Keep in mind that there are several treatments and non-surgical or minimally invasive procedures I may recommend for my patients before I consider…
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The Benefits of Being Proactive About Your Spine

October 14,2016
"Sooner than later" increases your treatment options for your herniated disc. Have you developed chronic and persistent pain somewhere along your spine - maybe your neck or between the lower portion of your ribs and your hips? Are you in your 30s or 40s or later? It's possible that you have a herniated disc. You should see your doctor for a check-up and have your back examined by a qualified…
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An Apple A Day

September 30,2016
The surprising health benefits of Apple Cider Vinegar.   I heard it from every adult in my youth: An apple a day keeps the doctor away. To be honest, I still keep that rule. Not because I believe that apples will actually prevent disease (which they won’t), but because I have found that they keep me mindful of my long-term goals of doing all that I can to stay healthy.…
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Use Your Food

September 16,2016
Nutrition is the key to curing more than your need to eat. Maybe you've heard the locker room mantra: Train hard or go home. Anyone who has ever dedicated themself to a serious workout plan knows that this is true. There's nothing gained from a half-hearted plan. You might as well stay home and binge on YouTube videos.   And yet, being greater than better is more than grunt and…
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Not Your First and Only Option

September 09,2016
Back pain? Neck pain? What are your options? A friend of mine is an avid cyclist. When I met him, he had just turned 55 and just completed his fourth ‘century’ (100 miles) ride. He came to me experiencing numbness in his right arm and fingers and persistent but manageable pain above the shoulder area of his neck. An MRI revealed two ruptured discs in the region of the neck…
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The Pain in Your Neck

August 26,2016
Are you at risk as a potential disc replacement patient?   If you are experiencing persistent, chronic pain in your neck, you could be exhibiting symptoms of a ruptured cervical disc (see a doctor for a diagnosis). How did it happen? Was it the result of a direct injury like a fall or a car accident? Was it from an indirect injury caused by long-term repetitive movement or athletics? It’s…
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A Doctor’s Journey

August 12,2016
What has happened to me in my journey to 4D Health.  My journey began like many of my patients. One day, I developed chronic pain in my lower back that steadily grew worse over the years. I tried to cope with the pain the way we all do, but nothing was working. Ultimately, the pain was so great that I had to limit certain physical activities. My energy level was…
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Aging Management as a Choice

July 29,2016
Examining the “4D Health” process as an alternative for a sedentary life. I knew a couple who lived in the Thousand Oaks area. When I met them, they were entering their 70s and had been happily married nearly 50 years. Both of them had long-term health problems: including arthritis and osteoporosis. He had the added pain of advanced degenerative disc disease. What surprised me was that despite their diagnosis, they…
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Movement is Life

July 15,2016
How "Take it Easy" is really the last thing we should do.   As my grandparents got older, they were constantly encouraged to "take it easy." And so they did. They became sedentary, spending more time sitting around playing cards and sipping drinks on the porch. As time passed, they grew weaker and weaker. With each day it seemed they grew less active and more dependent upon others to do things for…
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Be Greater than Better

July 01,2016
How the Fourth Dimension of Health Does More than Make You Better As a neurosurgeon, I specialize in spinal surgery. But my work is more than surgery. My work begins with assessing what I call the fourth dimension of health. As we live longer, we want to be more active and functional as we age. We aim for a  quality of life that is often greater than what our parents…
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Patients maintain clinical benefits 7 years after two-level cervical disc replacement

May 05,2016
CHICAGO — At the American Association of Neurological Surgeons Annual Meeting, Todd H. Lanman, MD, FAANS, spoke about the long-term results of a prospective, randomized, controlled multicenter FDA-approved clinical trial of the Prestige LP Cervical Disc (Medtronic) implanted at two adjacent levels. The low-profile titanium ceramic composite-based artificial cervical disc is indicated for single-level cervical disc disease causing nerve or spinal cord compression from C3 to C7, and is pending…
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AGING MANAGEMENT – WHAT WE CONSIDER

March 31,2016
Bone health: Bone health can be improved using vitamin D at least 2000 international units a day with calcium with a minimum of 1200 mg a day. I often recommend particularly the patients in Southern California to markedly increase their vitamin D. These supplements are highly in medical grade and resolvable are provided by me.  I usually prescribe 10,000 units of vitamin D with a bone supplement, which contains calcium,…
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DR. LANMAN’S PERSONAL JOURNEY

March 31,2016
All the areas of the recommendations that I have designed in the treatment of my spine patients were derived from my own personal experience having undergone four spine surgeries over the last 11 years. I am fully functional, I am able to ski, swim, surf, hike, and be fully active in weight training and cardiovascular exercise. I freely admit that I have modified my nutrition in the similar way that…
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THE EFFECTS OF BAD ADVICE

March 31,2016
I see many patients who have been given what I consider to be bad advice. These are the patients who have been told wait until your back is so bad that you have to crawl into the doctor to get your back surgery. This was the advice given to patients who needed hip and knee replacement surgery years ago. We now know that advice is probably bad advice because when…
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