SPINAL CARE IN THE NORTH EAST
Mr Palaniappan (Pal) Lakshmanan
MBBS, MS (Orth), AFRCS, FRCS (Tr & Orth)
Understand your symptoms. Explore your options. Personalised care for back pain, neck pain and spinal conditions, with an experienced Consultant Orthopaedic Spinal Surgeon.
Spire Washington Hospital · Virtual consultations available
Consultant Spinal Surgeon
GMC registration 6038229MEET YOUR CONSULTANT
A careful assessment.
A clear conversation.
A plan that fits you.
Mr Palaniappan (Pal) Lakshmanan is a Consultant Orthopaedic Spinal Surgeon with more than 16 years of consultant practice. Based in the North East, he welcomes patients from throughout the UK.
Back and neck problems can affect much more than movement. Mr Lakshmanan’s approach starts with listening carefully to each patient’s symptoms and understanding their impact on everyday life. He explains suitable treatment options clearly, helping patients make informed decisions about their care.
He became a consultant at Sunderland Royal Hospital in 2010 and has practised at Spire Washington Hospital since 2011. He completed a 12-month fellowship in complex and minimally invasive spinal surgery at Queen’s Medical Centre, Nottingham, followed by further minimally invasive and microsurgical training at the AO Spine Centre in Munich.
View his Spire consultant profile , opens in a new tabRESEARCH & EDUCATION
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
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
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
As first author, Mr Lakshmanan has published work on why spinal injuries occur, how spinal changes are classified, and techniques for treating complex conditions.
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)
He and his co-authors 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
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
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
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.
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 tabRESULTS IN CONTEXT
Selected measures from the National Consultant Information Programme, compared with the national rate for the same procedure category and reporting view.
APRIL 2023 – MARCH 2026 · THREE-YEAR VIEW · ALL REPORTING PROVIDERS
Recorded return for a further cervical or lumbar spinal surgical procedure, as applicable to the original procedure category.
| Procedure category | Mr Lakshmanan | National rate |
|---|---|---|
| Anterior cervical surgery | Mr Lakshmanan0.51%1 / 195 | National rate2.58%334 / 12,961 |
| Primary lumbar decompression / discectomy | Mr Lakshmanan2.02%7 / 346 | National rate4.90%2,045 / 41,735 |
| Primary one- or two-level lumbar fusion | Mr Lakshmanan0.55%2 / 362 | National rate2.69%218 / 8,118 |
All-cause emergency readmission within 30 days of discharge, shown for selected procedure categories.
| 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 |
These are recorded, unadjusted rates. Differences in patients’ age, diagnosis and complexity affect comparisons. Further surgery and readmission can have many causes; these figures do not establish treatment success or predict an individual patient’s outcome.
Recorded three-year activity in these categories: 166 anterior cervical procedures, 330 primary lumbar decompression / discectomy procedures and 286 primary lumbar fusions.
Source: NCIP, “Summary of providers”, combining South Tyneside and Sunderland NHS Foundation Trust and Spire Healthcare; checked 16 September 2026. These are the consultant figures for Mr Lakshmanan, compared with the national aggregate rate, not the average of individual consultants’ rates. The numbers beneath each percentage are events / eligible patients or records in the NCIP denominator.
The index categories are elective procedures in patients aged 17 and over. “Anterior cervical surgery” is the NCIP category “Anterior cervical spine decompression / fusion / disc replacement”. The other categories are “Primary posterior lumbar decompression / discectomy” and “Primary one- or two-level posterior lumbar fusion surgery”. Each comparison uses the same NCIP metric and reporting view.
Follow-up measures use their own eligible historical cohorts. Their denominators differ from headline activity counts, and two-year follow-up must not be interpreted as complete follow-up of everyone treated during April 2023–March 2026. Activity is attributed through the responsible-consultant field and is not a count of unique patients or all procedures personally performed.
NCIP covers NHS care, NHS-funded independent-sector care and privately funded care in NHS hospitals. It does not represent all privately funded independent-sector activity. These are selected measures, not an overall ranking or a complete assessment of every aspect of care. Read about NCIP , opens in a new tab
HOW HE CAN HELP
Assessment and treatment of conditions affecting the neck, middle back and lower back.
Specialist assessment of back pain and spine-related leg symptoms.
Care for conditions affecting the cervical spine and its nerves.
A particular interest in spinal problems associated with ageing and bone health.
Experience with a broad range of spinal disorders and injuries.
YOUR TREATMENT OPTIONS
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 appointmentDepending on the condition, options may include nerve root blocks, facet joint injections or caudal epidural injections.
Specialist techniques used for selected spinal conditions. Suitability depends on the problem being treated and your individual assessment.
Surgical treatment for selected conditions involving pressure on spinal nerves. Your consultation will cover whether this is an appropriate option.
Procedures considered for specific spinal conditions, including instability and selected disc problems. The recommendation is based on your diagnosis and individual circumstances.
Treatment options for selected patients with spinal fractures, including fractures associated with osteoporosis.
“Your skill and experience, and compassionate care played a huge part in my recovery.”
“I was extremely nervous and anxious about the process, however everyone was so friendly and supportive throughout”
“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.”
“It’s given me a new and brighter future with less pain.”
“To all of the team that helped me, operated and looked after me I truly appreciate you all.”
“Thank you so very much for giving me my life back.”
“Many thanks for seeing me so quickly and organising my MRI at such short notice.”
“What could have been a frightening experience was alleviated by their professionalism and kindness.”
“Thank you could never be enough”
“the staff were very thoughtful.”
“I truly can’t say how much I appreciate what you’ve done for me.”
Selected feedback, shared anonymously. Individual experiences may vary.
TAKE THE NEXT STEP
Arrange a private consultation at Spire Washington Hospital to discuss your symptoms and explore suitable treatment options.
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.
FOR SOLICITORS & LEGAL TEAMS
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.
Assessment of injury, likely recovery, future treatment and rehabilitation needs, and the effect on everyday activities.
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
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
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
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