Back pain & sciatica
Specialist assessment of back pain and spine-related leg symptoms.
- Slipped discs
- Trapped nerves
- Spinal stenosis
- Spinal instability
SPINAL CARE IN THE NORTH EAST
Specialist Spine Care.
Centred on you.
Mr Palaniappan (Pal) Lakshmanan
MBBS, MS (Orth), AFRCS, FRCS (Tr & Orth)
More than 16 years of consultant practice, with advanced spinal training in Nottingham and Munich. Private assessment and treatment at Spire Washington Hospital, from targeted injections to complex spinal surgery.
Spire Washington Hospital · UK and international patients welcome
Consultant Spinal Surgeon
GMC registration 6038229MEET YOUR CONSULTANT
Your consultant,
Pal Lakshmanan.
Specialist training.
Established experience.
Care shaped around you.
Mr Palaniappan (Pal) Lakshmanan has been a Consultant Spinal Surgeon at Sunderland Royal Hospital since 2010 and has practised at Spire Washington Hospital since 2011.
His training includes a 12-month fellowship in complex and minimally invasive spinal surgery at Queen’s Medical Centre, Nottingham, and further training in minimally invasive surgery and microsurgery at the AO Spine Centre in Munich.
His practice includes surgery for trapped nerves, spinal stenosis and spinal instability, as well as care for spinal fractures, deformity, tumours and infection. He has a particular interest in the ageing spine, including osteoporosis-related fractures.
He combines this surgical experience with targeted spinal injections and careful discussion of the available options. Consultations focus on understanding the diagnosis, explaining the benefits and risks of treatment, and agreeing a plan that fits the patient’s circumstances.
He welcomes patients from the North East, throughout the UK and internationally, with in-person and virtual consultations available in English and Tamil.
View his Spire consultant profile , opens in a new tabEducation & qualifications
- FRCS (Trauma & Orthopaedics)Intercollegiate Specialty Examination, 2008.
- AFRCSRoyal College of Surgeons in Ireland, 2003.
- MS (Orthopaedics)Madras Medical College, Chennai, India, 2001.
- MBBSCoimbatore Medical College, India, 1996. Awarded Best Outgoing Student.
Professional memberships
- British Association of Spine Surgeons
- North American Spine Society
- AO Spine
- Tamil Nadu Orthopaedic Association
- Royal College of Surgeons in Ireland
HOW HE CAN HELP
From everyday pain
to complex spinal problems.
Assessment and treatment of conditions affecting the neck, middle back and lower back.
Neck pain & nerve symptoms
Care for conditions affecting the cervical spine and its nerves.
- Cervical disc problems
- Nerve compression
- Degenerative changes
The ageing spine
A particular interest in spinal problems associated with ageing and bone health.
- Osteoporosis
- Spinal fractures
- Degenerative scoliosis
- Kyphosis
Complex & other conditions
Experience with a broad range of spinal disorders and injuries.
- Spinal trauma
- Tumours and infections
- Sacroiliac joint problems
- Coccyx pain
YOUR TREATMENT OPTIONS
The right approach
for your condition.
Mr Lakshmanan’s practice includes spinal injections and a wide range of surgical techniques. He has a particular interest in minimally invasive and microsurgical procedures.
Your consultation is an opportunity to understand which options may be suitable for you.
Arrange an appointmentSpinal injections
Depending on the condition, options may include nerve root blocks, facet joint injections or caudal epidural injections.
Minimally invasive & microsurgical techniques
Specialist techniques used for selected spinal conditions. Suitability depends on the problem being treated and your individual assessment.
Spinal decompression
Surgical treatment for selected conditions involving pressure on spinal nerves. Your consultation will cover whether this is an appropriate option.
Fusion, stabilisation & disc replacement
Procedures considered for specific spinal conditions, including instability and selected disc problems. The recommendation is based on your diagnosis and individual circumstances.
Vertebroplasty & kyphoplasty
Treatment options for selected patients with spinal fractures, including fractures associated with osteoporosis.
SURGICAL RESULTS
His results.
The national comparison.
Selected results from the National Consultant Information Programme (NCIP), alongside the national rate for the same procedure and measure.
APRIL 2023 – MARCH 2026 · THREE-YEAR REPORTING VIEW · ALL REPORTING PROVIDERS
Further surgery within two years
For each of the three elective procedure groups below, his recorded rate of further spinal surgery is lower than the corresponding national rate.
Anterior cervical surgery
Surgery through the front of the neck
- Mr Lakshmanan
- 0.51%1 / 195
- National rate
- 2.58%334 / 12,961
Primary lumbar decompression / discectomy
Surgery to relieve pressure on nerves in the lower back
- Mr Lakshmanan
- 2.02%7 / 346
- National rate
- 4.90%2,045 / 41,735
Primary one- or two-level lumbar fusion
Surgery to stabilise one or two levels of the lower back
- Mr Lakshmanan
- 0.55%2 / 362
- National rate
- 2.69%218 / 8,118
These are selected, unadjusted rates, with events / eligible records shown beneath each percentage.
Recorded surgical activity
Procedure counts attributed to Mr Lakshmanan in the same three-year reporting view.
166Anterior cervical procedures
330Primary lumbar decompressions / discectomies
286Primary one- or two-level lumbar fusions
Selected procedure categories, not a career total or a count of unique patients.
Time in hospital
The proportion of records with a hospital stay longer than the threshold shown.
| Procedure category | Mr Lakshmanan | National rate |
|---|---|---|
| Anterior cervical surgery: stay longer than 1 day | Mr Lakshmanan4.82%8 / 166 | National rate30.98%4,474 / 14,442 |
| Primary lumbar decompression / discectomy: stay longer than 1 day | Mr Lakshmanan2.42%8 / 330 | National rate27.25%13,008 / 47,733 |
| Primary one- or two-level lumbar fusion: stay longer than 2 days | Mr Lakshmanan8.39%24 / 286 | National rate43.99%3,552 / 8,074 |
Emergency readmission within 30 days
All-cause emergency readmission after discharge, for the selected procedure groups shown.
| Procedure category | Mr Lakshmanan | National rate |
|---|---|---|
| Anterior cervical surgery | Mr Lakshmanan1.79%3 / 168 | National rate3.96%572 / 14,442 |
| Primary lumbar decompression / discectomy | Mr Lakshmanan1.79%6 / 335 | National rate4.71%2,245 / 47,623 |
Sources, definitions and how to read the figures
Source: Mr Lakshmanan’s NCIP reports, “Summary of providers”, with no additional filters, generated 21 July 2026 and reviewed 23 September 2026. Reporting view: April 2023–March 2026. Comparisons use the national aggregate rate in the report, not an average of individual consultants’ percentages or a ranking of surgeons.
These elective procedure groups include patients aged 17 and over. “Anterior cervical surgery” is the NCIP category “Anterior cervical spine decompression / fusion / disc replacement”. The lumbar categories are “Primary posterior lumbar decompression / discectomy” and “Primary one- or two-level posterior lumbar fusion surgery”. Further surgery refers to a subsequent cervical or lumbar spinal surgical procedure, as applicable.
Follow-up measures have their own eligible historical cohorts. Their denominators differ from the activity counts, and two-year follow-up must not be read as complete follow-up of everyone treated during April 2023–March 2026. Activity is attributed through the responsible-consultant field. Duplicate copies of the lumbar decompression report are counted once.
NCIP covers NHS care, NHS-funded independent-sector care and privately funded care in NHS hospitals. It does not capture all privately funded independent-sector activity. Read about NCIP , opens in a new tab
Patient testimonials
“Because of you, I’m walking, moving around and feeling happy again.”
“Thank you so much for your expertise and for sorting my back problem. It’s given me a new and brighter future with less pain.”
“Many thanks for seeing me so quickly and organising my MRI at such short notice.”
“Your care is always so efficient and personalised. I am extremely grateful.”
“Thank you so much for your care and concern, you are truly a professional surgeon with a lovely pleasant manner.”
“Thank you so very much for giving me my life back.”
Selected feedback, shared anonymously. Individual experiences may vary. Emphasis added.
TAKE THE NEXT STEP
Expert advice for
your spinal health.
Arrange a private consultation at Spire Washington Hospital to discuss your symptoms and explore suitable treatment options.
CLINIC PREMISES
Washington
Tyne and Wear, NE38 9JZ
Spire Washington Hospital
Picktree LaneWashington
Tyne and Wear, NE38 9JZ
In-person and virtual consultations
Consultations in English and Tamil
Appointments can be booked online with Spire or arranged through Mr Lakshmanan’s secretary. Please confirm current fees, availability and any insurance requirements when booking.
RESEARCH & EDUCATION
Research that informs
spinal care.
Mr Lakshmanan combines clinical practice with original research, published surgical techniques and local leadership in national clinical trials.
He is the local Principal Investigator for POLYFIX-DCM and FORENSIC-UK, leading these studies at his hospital. This work contributes to the evidence that helps patients and surgeons make informed treatment decisions together.
LOCAL PRINCIPAL INVESTIGATOR
POLYFIX-DCM
Studying surgery for spinal cord compression in the neck. The trial compares surgery to relieve pressure on the spinal cord with or without additional fixation and fusion, for people with degenerative cervical myelopathy.
About POLYFIX-DCM , opens in a new tabLOCAL PRINCIPAL INVESTIGATOR
FORENSIC-UK
Comparing lumbar spinal fusion with personalised non-surgical care for people with severe, persistent lower back pain. The study aims to clarify which approach offers greater benefit when previous non-surgical treatment has not helped enough.
About FORENSIC-UK , opens in a new tabHis previous research involvement also includes PRAISE trial information, opens in a new tab, a trial comparing approaches to pain relief after spinal surgery.
ORIGINAL CONTRIBUTIONS
Original research & surgical innovation
As first author, Mr Lakshmanan has published work on why spinal injuries occur, how spinal changes are classified, and techniques for treating complex conditions.
Understanding neck fractures in older people
His research proposed a hypothesis explaining how arthritis in the upper neck may contribute to odontoid fractures after minor falls. The odontoid is the small bony peg near the top of the spine that helps the head turn.
Read the odontoid fracture study , opens in a new tabEuropean Spine Journal · 2005 (published online in 2004)
Classifying upper-neck arthritis & bone loss
He described grading systems for the severity of atlanto-odontoid arthritis, lateral atlantoaxial osteoarthritis and osteoporosis affecting the odontoid and adjacent bone. These provide a structured way to describe joint wear and bone loss on CT scans.
View the published grading systems , opens in a new tabEuropean Spine Journal · 2005
Understanding lumbar shape & implant fit
His study classified the shape of the bony surfaces bordering the discs in the lower back, known as vertebral endplates. It described patterns relevant to the design and fit of spinal fusion and disc replacement implants.
European Spine Journal · 2012
Describing new surgical techniques
He and his colleagues published a technique using transsacral screws to stabilise and fuse the spine in high-grade spondylolisthesis, a severe forward slip of a spinal bone. This forms part of his contribution to the surgical literature on complex spinal conditions.
Read the surgical technique paper , opens in a new tabThe Spine Journal · 2009
Research leadership & publishing
He has served as Research Lead on the Executive Team of the British Association of Spine Surgeons and is a co-editor of its journal, Column & Cord. He also publishes research and teaches on national and international surgical courses.
Teaching the next generation
He has been Spine Lecturer on the JBJS Miller Oxford FRCS (Orth) Revision Course since its inception in 2011 and continues in this role.
Visit the course website and faculty , opens in a new tabFOR SOLICITORS & LEGAL TEAMS
Medicolegal expertise.
Independent opinion.
Mr Lakshmanan accepts instructions throughout the UK for personal injury and medical negligence cases involving spinal conditions and orthopaedic injuries. His expert witness practice began in 2010, with clinical negligence work from 2011.
Personal injury
Assessment of injury, likely recovery, future treatment and rehabilitation needs, and the effect on everyday activities.
Clinical negligence
Opinions on breach of duty and causation in spinal care, including delayed diagnosis, cauda equina syndrome and complications following treatment.
Available for claimant, defendant and Single Joint Expert instructions.
PUBLISHED COMMENTARY
Perspectives in Column & Cord
Mr Lakshmanan’s contributions to the journal of the British Association of Spine Surgeons address issues relevant to spinal care and medicolegal practice.
CAUDA EQUINA & GIRFT GUIDANCE
Commentary on the Cauda Equina Syndrome Pathway (CES) articles
A discussion of the national suspected cauda equina syndrome pathway, clinical judgement, practical implementation and implications for litigation.
Column & Cord · Issue 4 · March 2024 · pp. 14–15
Read the commentary (PDF, pp. 14–15), opens in a new tabSPINAL RADIOLOGY REPORTING
Response to “We Need To Talk About Spinal Radiology Reporting”
Mr Lakshmanan’s published response to the discussion on spinal radiology reporting, available through the journal’s online article collection.
Column & Cord · Volume 6 · 2026
Read the commentary on spinal radiology reporting, opens in a new tab