Professional background

Mr Sayal is the clinical lead for spinal surgery at the National Hospital for Neurology and Neurosurgery. Mr Sayal's practice encompasses the entire range of simple and complex spinal surgery and also endoscopic skull base surgery including:

  • Degenerative spinal conditions (patients with back pain, sciatica/leg pain, neck pain, arm pain, radiculopathy, myelopathy), spinal deformity / spinal instrumentation/ metalwork
  • Minimally invasive spinal surgery including surgery using tubes and endoscopic surgery.
  • Surgery for spinal tumours, intra-dural tumours, malignant spinal cord compression (MSCC), spinal blood vessel malformations.
  • Surgery for spinal infection, osteoporosis, spine fractures
  • Injections and facet denervation for spinal pain.

He is specialist for CSF leaks (spinal fluid leaks) / Spontaneous intracranial hypotension, and works with the Neurologists / Neuroradiologists and has specific expertise in the surgical repair of leaks: ventral leaks, leaks due to meningeal cysts / lumbar punctures, CSF Venous fistulae.

He is part of the UK working group for CSF leak / SIH guidelines. He also performs endoscopic anterior skull base surgeries for pathologies such as CSF leak, chordomas and chondrosarcomas amongst others with the ENT surgeons. He has a specialist interest in cervical deformity correction, metabolic spinal conditions such as MPS & XLH, Tarlov cysts, craniovertebral junction pathology, syringomyelia, superficial siderosis, spinal cord tumours and vascular malformations and minimally invasive spinal surgery.

Having graduated from medical school with numerous distinctions and medals, Mr Sayal was the first British neurosurgical trainee competitively chosen to pilot the Modernising Medical Careers' neurosurgical curriculum which he assisted in developing. He obtained his neurosurgical training in the Yorkshire Deanery and was the senior registrar for two years at The Royal Hallamshire Hospital, Sheffield. During this time he performed over 1500 neurosurgical procedures including surgery for brain tumors, Brain haemorrhage / aneurysm clippings, complex spinal surgery/instrumentation and open / endoscopic skull base surgery. Immediately after finishing his registrar training in 2013, he was appointed locum neurosurgical consultant at The Royal Hallamshire Hospital, Sheffield and the main remit of the job was complex spinal surgery and skull base surgery.

He then chose to take up the prestigious Sir Victor Horsley Spinal Fellowship at the National Hospital for Neurology and Neurosurgery (NHNN), and The Royal National Orthopaedic Hospital, Stanmore with the guidance of Mr Adrian Casey. This was a joint neurosurgery and orthopaedic spinal fellowship and this places him with the unique advantage of having expertise across the entire spectrum of spinal surgery. He was chosen competitively for the prestigious British Association of Spinal Surgeons' Travelling fellowship and also awarded the Best presentation prize at the 2015 British Association of Spinal Surgeons' meeting. He followed this up with a further four-month fellowship at Queen Square performing endoscopic anterior skull base surgeries and complex spinal tumour surgery.

He was appointed consultant neurosurgeon at NHNN in 2016, He has also provided cover for the sabbatical of two senior neurosurgeons (Mr Casey and Mr Allibone) and managed some of the most complex spinal cases during this period. Mr Sayal has presented extensively in national and international neurosurgical meetings/conferences and collaborated in over 75 scientific abstracts.

He has a keen interest in teaching and has trained senior spinal fellows who have gone on to become spinal surgery consultants in other hospitals. He has been invited to deliver neurosurgical lectures to a wide range of specialities including neurosurgeons / orthopaedic spinal surgeons, musculoskeletal physiotherapists, rheumatologists, emergency medicine, nursing professionals, UCL medical students.

He is currently the lead for spinal surgery Queen Square and is the course director and faculty for numerous neurosurgery courses. He has been awarded the “ UCLH Excellence in Education “ prize and also the Best Neurosurgery Trainer Award.

Research interests

Current research interests include outcomes of robotic spinal surgery, outcomes of minimally invasive spinal surgery, spinal manifestations of metabolic bone conditions, outcomes of surgery for Superficial Siderosis and CSF leaks / Spontaneous Intracranial Hypotension.

Mr Sayal was part of the SITRAN / University of Sheffield project exploring the fanconi anaemia pathway in gliomas.

Languages spoken

German, Hindi


  • Chan E, Sammaraiee Y, Banerjee G, Martin AF, Farmer S, Cowley P, Sayal P, Kharytaniuk N, Eleftheriou P, Porter J, van Harskamp N, Cipolotti L, Werring DJ. Neuropsychological and neuroimaging characteristics of classical superficial siderosis. J Neurol. 2021 Nov;268(11):4238-4247. doi: 10.1007/s00415-021-10548-z. Epub 2021 Apr 17. PMID: 33866413.
  • Kharytaniuk N, Cowley P, Sayal P, Eleftheriou P, Farmer SF, Chan E, Bamiou DE, Werring DJ. Classical infratentorial superficial siderosis of the central nervous system: pathophysiology, clinical features and management. Pract Neurol. 2022 Jul 11:practneurol-2021-003324. doi: 10.1136/practneurol-2021-003324. Epub ahead of print. PMID: 35817559.
  • Khan DZ, Bandyopadhyay S, J, Halliday J, Kolias AG, Mannion RJ, O'Donnell A, Santarius T, Sayal P, Marcus HJ; CSF rhinorrhoea after endonasal intervention to the anterior skull base (CRANIAL): proposal for a prospective multicentre observational cohort study. Br J Neurosurg. 2021 Aug;35(4):408-417. doi: 10.1080/02688697.2020.1795622. Epub 2020 Sep 10. PMID: 32909855.
  • CRANIAL Consortium. CSF Rhinorrhea After Endonasal Intervention to the Skull Base (CRANIAL) - Part 2: Impact of COVID-19. World Neurosurg. 2021 May;149:e1090-e1097. doi: 10.1016/j.wneu.2020.12.169. Epub 2021 Jan 11. PMID: 33444833; PMCID: PMC7965443.
  • CRANIAL Consortium. CSF Rhinorrhoea After Endonasal Intervention to the Skull Base (CRANIAL) - Part 1: Multicenter Pilot Study. World Neurosurg. 2021 May;149:e1077-e1089. doi: 10.1016/j.wneu.2020.12.171. Epub 2021 Jan 11. PMID: 33444844; PMCID: PMC8105646.
  • Lobo R, Batbayar B, Kharytaniuk N, Cowley P, Sayal P, Farmer S, Werring DJ. Targeted detection and repair of a spinal dural defect associated with successful biochemical resolution of subarachnoid bleeding in classical infratentorial superficial siderosis. Neurol Sci. 2022 Sep;43(9):5643-5646. doi: 10.1007/s10072-022-06181-x. Epub 2022 Jun 13. PMID: 35691973; PMCID: PMC9385782.
  • A Novel Neurosurgery Referral Course: Feasibility, Validation, and Inferences for Patient Care. Pradini-Santos L, Craven CL, Usher I, Mullins S, D'Antona L, Al-Ahmad S, Abuhusain H, Sayal PP. J Surg Educ. 2020 Jun 10: S1931-7204(20)30132-X.
  • Extradural Compressive Spinal Cerebrospinal Fluid Leak in Ehlers-Danlos Syndrome. Pradini-Santos L, Craven CL, Sayal PP. World Neurosurg. 2019 Dec; 132:67-68.
  • Implementation of duty of candour within neurosurgery: a national survey and framework for improved application in clinical practice. Basu S, Marcus HJ, Sayal P, Kitchen N, Ley R, Hutchinson PJ, Thorne L. Ann R Coll Surg Engl. 2020 Feb;102(2):144-148.
  • FANCD2 expression is associated with glioma grade and chemical inhibition of the Fanconi Anaemia pathway sensitises gliomas to chemotherapeutic agents. Patil AA, Sayal P, Depondt ML, Beveridge RD, Roylance A, Kriplani DH, Myers KN, Cox A, Jellinek D, Fernando M, Carroll TA, Collis SJ. (1st co-author) Oncotarget. 2014 Aug 15;5(15):6414-24.
  • Spinal Cord Suspension Using Dentate Ligament Hitch Stitches: A Novel Technique for the Repair of Ventral Spinal Cord Herniation Lui J, Sayal P, Choi D Oper Neurosurg (Hagerstown). 2018 Mar 1;14(3):252-258.
  • The role of anterior cervical osteophytectomy in the management of dysphagia secondary to anterior cervical hyperostosis in diffuse idiopathic spinal hyperostosis. Lui J, Sayal P, Prezerakos G, Russo V, Choi D, Casey A Clinical Neurology and Neurosurgery Clin Neurol Neurosurg. 2018 Apr; 167:36-42.
  • Paravertebral tumours of the cervicothoracic junction with mediastinal extension. Surgical strategies in a no man's land.
  • Prezerakos G, Sayal P, Ladas G, Casey A European Spine Journal Eur Spine J. 2018 Apr;27(4):902-912.
  • Outcome of adult patients with X-linked hypophosphatemia caused by PHEX gene mutations. Chesher D, Oddy M, Durber U, Sayal P, Casey A, Ryan A, Sechi A , Simister C , Waters A , Wedatilake Y, Lachmann R , Murphy E. Journal of Inherited Metabolic disease. J Inherit Metab Dis. 2018 Feb 19.
  • Gebreyohanes A, Zubair A, Lui J, Casey A, Sayal P. Iatrogenic dorsal spinal cord herniation and repair with clip-based expansile duraplasty: a case report. Spinal Cord Ser Cases. 2022 Mar 28;8(1):36. doi: 10.1038/s41394-022-00505-x. PMID: 35347110; PMCID: PMC8960805.
  • A Rare case of concomitant Glioblastoma multiforme with Herpes Encephalitis Sayal P, Zafar A, Highley R. Asian J Neurosurg. 2018 Jan-Mar;13(1):78-82.
  • Radiotherapy related aneurysms: A role for conservative management Sayal P, Zafar A, Rajaraman C Surgical Neurology International, Cerebrovascular Suppl 2016.
  • Syringomyelia secondary to “occult” dorsal arachnoid webs: Report of two cases with review of literature Sayal P, Zafar A, Carroll T. J Craniovertebr Junction Spine. 2016 Apr-Jun 7(2).
  • Neuroprotective effects of vitamin E in cold induced cerebral injury in guinea pigs. Badhe P, Thorat J, Diyora B, Mamidanna R, Sayal P, Sharma AK. J Exp Biol. 2007 Feb; 45:180-4.
  • Orbital subperiosteal hematomas associated with subfrontal extradural hematoma. Sharma AK, Diyora BD, Sayal PP, Ingale HA, Mamidana R J Trauma. 2007 Feb; 62(2):523-5.
  • Spinal intramedullary arachnoid cyst in a 4-year-old girl: a rare cause of treatable acute quadriparesis: case report. Sharma A, Karande S, Sayal P, Randive N J Neurosurg. 2005 May; 102(4 Suppl):403-6. Selected for cover page of MAY 2005 Issue
  • Intracranial penetration of a glass piece through the temporal region in civilian head injury. Sharma A, Pandey A, Diyora B, Shah S, Sayal P J Trauma. 2006 Apr; 60(4):891-3.
  • Inadvertent insertion of nasogastric tube into the brain. Pandey AK, Sharma AK, Diyora BD, Sayal PP, Ingale HA, Radhakrishnan M. J Assoc Physicians India. 2004 Apr; 52:322-3.
  • Spinal intramedullary arachnoid cysts. Sharma A, Sayal P, Badhe P, Pandey A, Diyora B, Ingale H. Indian J Pediatr. 2004 Dec;71(12):1144.
  • Management of ventriculo-peritoneal shunt protruding through anus. Sharma A, Pandey AK, Diyora B, Shah S, Sayal P. Indian J Surg [serial online] 2006; 68:173-173.
  • Abdominal CSF pseudocyst in a patient with ventriculo-peritoneal shunt Sharma A, Pandey AK, Diyora B, Mamidanna R, Sayal P, Ingale H Indian J Surg. 2005 Jan;66(6): 360-63.