Low back pain has become a global public health challenge with adverse medical, occupational and socio-economic implications. Identification of patients whose back pain is dominated by neurogenic mechanisms is recommended to avoid chronicity and disability. Various diagnostic tools and procedures including neuropathic pain screening questionnaires, clinical neurological examination and radiological imaging procedures, such as magnetic resonance imaging, are widely utilized by clinicians in the assessment of patients suspected of having low back and leg pain of predominantly neuropathic origin. The diagnostic sensitivity, specificity and reliability of some of these tools and procedures are controversial and their correlation has been insufficiently evaluated. The aim of the current study is therefore to establish the correlation between the Self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) score, clinical neurological examination (CNE) findings and Magnetic Resonance Imaging (MRI) findings in patients with lumbo-sacral radiculopathy.

The study will be a hospital-based multi-center study in the Republic of Kenya, with a cross-sectional quantitative design in three stages. Stage 1 will involve conducting two systematic literatures reviews to determine the diagnostic value of, firstly, MRI and, secondly, CNE findings, in detecting lumbo-sacral radiculopathy. Stage 2 will involve standardization of a CNE procedure, as well as a MRI reporting protocol for the lumbo-sacral spine in the Kenyan setting. Stage 3 will consist of correlating the findings of the S-LANSS score, CNE and of MRI reports in a consecutively selected sample of participants. Data will be collected using a self-developed data sheet, the Oswestry Disability Index, S-LANSS questionnaire, CNE form, and an adopted MRI reporting protocol for the lumbo-sacral spine. Data will be analyzed using the SPSS 19.0. Bivariate analysis will be used to calculate associations between items of S-LANSS score and CNE findings to MRI findings of lumbo-sacral radiculopathy. The Pearson’s Chi-square test will be used to assess the significance of these associations. Concordance correlation test will be used to analyze the correlation between S-LANSS scores, CNE findings and MRI reports.