title: Spondylolysis and spondylolisthesis: what the primary care provider should know.
abstract: OBJECTIVE
  To provide nurse practitioners (NPs) with an overview of spondylolysis and spondylolisthesis, including the pathophysiology and etiology, incidence and prevalence, clinical presentation, diagnosis and differentials, management, and prognosis for these conditions.
  
  
  METHODS
  Selected research, reviews, and clinical articles, and the authors' experience.
  
  
  CONCLUSIONS
  Spondylolysis and spondylolisthesis are two common and confusing diagnoses identified by healthcare providers in the treatment of low back pain. Symptoms can vary depending on the degree of disarticulation with radiculopathy occurring in advanced grades of spondylolisthesis. Standing, lateral lumbosacral radiographs remain the gold standard for diagnosis. The majority of patients will improve with conservative treatments. Surgical options are warranted after 6 months of failed conservative treatments for patients with radiculopathy, neurogenic claudication, progressive neurological deficits, high-grade slips, or bladder and bowel symptoms.
  
  
  CONCLUSIONS
  NPs can distinguish these diagnoses and perform appropriate conservative management prior to referral to specialists for surgical evaluation. NPs are important providers in interdisciplinary care by assisting patients with both psychosocial and physical management of their back pain.
authors.affiliation: (Family Nurse Practitioner), Orthopedic Spine Clinic, Parkland Health and Hospital System, Dallas, Texas (Professor), Texas Woman's University, T. Boone Pickens Institute of Health Sciences - Dallas Center, Dallas, Texas (Professor), HOMES Program, Parkland Health and Hospital System, Dallas, Texas.
authors.forename: Robert
authors.initials: R
authors.lastname: Metzger
authors.forename: Susan
authors.initials: S
authors.lastname: Chaney
mesh_terms: D057179:Advanced Practice Nursing; D006801:Humans; D011320:Primary Health Care; D013168:Spondylolisthesis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
keywords: Spondylolysis; low back pain; nurse practitioner; primary care; spondylolisthesis