Clinical protocols for lumbar nerve root compression and radiculopathy are often adopted without formal evidence that their content is valid, that they can be followed in practice or that patients treated under them achieve meaningful improvement. This paper sets out a staged validation design for a patient-centred spinal decompression protocol. Stage one uses a modified Delphi process in which a multidisciplinary panel rates each protocol statement for relevance over two to three rounds, with consensus defined as at least 75% agreement. Stage two quantifies content validity with the item-level and scale-level content validity indices and a modified kappa that adjusts for chance agreement; for a panel of ten, an item is retained when at least eight experts rate it relevant. Stage three is a prospective single-arm pilot that records pain, disability, walking capacity, neurological status, quality of life, satisfaction and complications from baseline to 12 months. Analytical calculations show that detecting a mean improvement of 10 points on the Oswestry Disability Index with a standard deviation of change of 20 requires 34 patients at 80% power and 44 at 90%, whereas estimating the responder proportion to within ±10 percentage points requires about 97. Stage four embeds the protocol in plan–do–study–act audit cycles. The design gives explicit decision rules for retaining, revising or rejecting protocol content; no patient data are reported.

Badal Biswas, Dr. Jagat Bahadur Rawat,"Validation Design for a Patient-Centred Spinal Decompression Protocol: Delphi Consensus, Content Validity and Prospective Outcome Evaluation" International Journal of Advanced Multidisciplinary Research and Educational Development, V2(5): Page(867-873) September - October 2026. ISSN: 3107-6513. www.ijamred.com. Published by Scientific and Academic Research Publishing.