Thoracic Lumbar Sacral Orthosis (TLSO) Brace


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TLSO (Thoracic Lumbar Sacral Orthosis)

A TLSO is typically a two-piece clamshell design. It may also be a single piece with an opening on the front. A TLSO extends from just below the collar bones down to the pelvis. It is used to stabilize the spine after surgery or in the event of a spinal fracture to promote healing and decrease pain.


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ApplicationTLSO (Thoracic Lumbar Sacral Orthosis)

  1. Apply a snug fitting cotton t-shirt or body sock. Loose shirts may cause wrinkles and skin irritation.
  2. While laying down in bed, log roll to the side to allow caregiver to assist in putting on TLSO.
  3. Caregiver should place the back portion on the patient, matching the grooves in waist of TLSO with patient’s waist (the soft area between the hips and ribs).
  4. Patient should gently roll onto back. Caregiver should confirm that TLSO has not moved and is still in proper position. Adjust accordingly.
  5. Place the front portion on patient, with the sides overlapping the back portion.
  6. Fasten the middle straps first. Pull straps at the same time to ensure even tightening and prevent twisting of the brace. Straps should be snug to hold TLSO in place, however, allow normal breathing.
  7. Fasten top and bottom straps in same manner.

Wearing Schedule

Always check with prescribing doctor for a precise wearing schedule. Many times the TLSO is worn only when out of bed while sitting or standing. Other times, the doctor requires the TLSO to be worn at all times.

Cleaning and Maintenance

Rubbing alcohol may be used to clean the inside and outside of the TLSO. Spray TLSO with alcohol and wipe gently with a cloth. Be sure that TLSO is completely dry prior to application to ensure no skin issues will occur. Always wear a clean, dry, snug fitting shirt under the brace.

Tips and Problem Solving

  • Avoid soft chairs and sit up straight. Leaning back into a chair will cause the brace to migrate upward and may place pressure underarms.
  • Do not lean forward over a table while eating. Bring the food up to the mouth. This will reduce any pressure on thighs and chest.
  • If the TLSO starts to migrate upward under throat/armpits, ensure that straps are snug. Straps that are loose will allow brace to shift.

If you experience any problems, please contact your orthotist.