The presence of fear of movement is related to higher disability rates in several patient groups. The purpose of this study was first to analyze fear of movement and the relation with pain and disability in pre-operative patients with low back pain and radiculopathy and secondly to analyze the factor structure of the Dutch version of the Tampa Scale for Kinesiophobia (TSK). The TSK and Pain Disability Index (PDI) were assessed in 128 patients. An explorative factor analysis (EFA) and a confirmatory factor analysis (CFA) of the TSK were performed using Structural Equation Models (SEMs). Fear of movement was significantly related to leg-pain and pain disability. A four-factor model had an explained variance of 49%. After further analyses a solution with three factors (harm, somatic focus, activity avoidance) and nine items (1, 3, 6, 7, 9, 11, 14, 15, 17) had the best fit. Based on the content of this study clinically a factor structure with three subscales with nine items is favorable for usage in pre-operative patients with low back pain and radiculopathy. Copyright © 2010 Elsevier Ltd. All rights reserved.