Thoracic Lumbar Sacral Orthosis (TLSO) Brace


CARE AND USE OF YOUR DEVICE

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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.

How to Put on a TLSO Back BraceTLSO (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 the caregiver to assist in putting on TLSO.
  3. The caregiver should place the back portion on the patient, matching the grooves in the waist of TLSO with the patient’s waist (the soft area between the hips and ribs).
  4. The patient should gently roll onto the back. The caregiver should confirm that TLSO has not moved and is still in the proper position. Adjust accordingly.
  5. Place the front portion on the 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 the thighs and chest.
  • If the TLSO starts to migrate upward under the throat/armpits, ensure that straps are snug. Straps that are loose will allow the brace to shift.

If you experience any problems, please contact your orthotist.

Other types of TLSO braces include:

Cervical Thoracic Lumbar Sacral Orthosis (CTLSO)

A CTLSO is a two-piece clamshell design.  It is used to stabilize the head and neck as well as the spine after surgery or in the event of a spinal fracture to promote healing and decrease pain.

ApplicationCTLSO

  • Apply a snug-fitting cotton t-shirt or body sock. Loose shirts may cause wrinkles and skin irritation.
  • While laying down in bed, log roll to the side to allow the caregiver to assist in putting on CTLSO.
  • The caregiver should place the back portion on the patient, matching the grooves in the waist of the trunk portion of CTLSO with the patient’s waist. (The soft area between the hips and ribs.)
  • Patients should gently roll onto their back. The caregiver should confirm that CTLSO has not moved and is still in the proper position. Adjust accordingly.
  • Place the front portion on the patient, with the sides overlapping the back portion.
  • Fasten the middle straps on the trunk portion first. Pull straps at the same time to ensure even tightening and prevent twisting of the brace. Straps should be snug to hold CTLSO in place, however, allow normal breathing.
  • Fasten top and bottom straps in the same manner.
  • Affix the chin strap on the headpiece, ensuring that straps are tight and providing motion control. If there is a forehead strap, fasten last.

Wearing Schedule

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

Cleaning and Maintenance

Rubbing alcohol may be used to clean the inside and outside of the CTLSO.  Spray CTLSO with alcohol and wipe gently with a cloth.  Be sure that CTLSO is completely dry prior to application to ensure no skin issues will occur.  The pads on the head/neck portion may be hand washed with mild detergent and laid flat to dry.

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 the thighs and chest.
  • If the CTLSO starts to migrate upward under the throat/armpits, ensure that straps are snug. Straps that are loose will allow the brace to shift.

Scoliosis TLSO (Thoracic Lumbar Sacral Orthosis)

A Scoliosis TLSO is a custom fabricated brace that is used to treat flexible curves in adolescents with scoliosis.  It should only be worn by the person for which the brace was prescribed.  The goal of the TLSO is to prevent the progression of the scoliotic curve.  The brace is typically worn 16-18 hours per day/night.  It may either have an opening in the front or the back.

Anterior (front) opening Posterior (back) opening
Anterior (front) opening Posterior (back) opening

Application

  1. Apply a snug-fitting shirt. Make sure there are no wrinkles.
  2. While standing, open the brace wide and slip into it. Align the waist pads in the brace with your natural waist (the area below your ribs).
  3. For an anterior opening TLSO, carefully lie down; make sure that the brace is still properly positioned on your waist. For a posterior opening TLSO, you may remain standing.
  4. Loop the straps through the metal chafes. Tighten to the marks as indicated by your Orthotist for appropriate tightness.

Wearing Schedule

The best way to break in the orthosis is to simply begin by wearing it.  It takes approximately (1) to (2) weeks to be able to wear a brace full time. It is typical to feel sore or achy as your body adjusts to the orthosis.  This will go away after a few days.  The TSLO may be removed for exercise, gym class, undershirt changes, and bathing.

Cleaning and Maintenance

It is important that you bathe daily to prevent any skin issues.  Always wear a clean, dry, snug-fitting shirt under the brace.  The nighttime brace may be cleaned with warm water and mild soap.  It may also be disinfected with rubbing alcohol.  Harsh cleaners, such as bleach, are not recommended due to the brace contacting your skin.  The padding will not absorb any of the cleaning liquids, however, wait until dry before wearing.

Tips & Problem Solving

  • It is normal for the redness to occur when wearing the orthosis, especially in areas of strong corrective pressure. As long as the redness fades and is not sensitive to the touch, it is not a cause for concern.
  • You may need to work your way up to the tightness marked on the straps during the break-in schedule. If you find that you are able to tighten the straps past the marks, please do so as it will enhance the correction your brace provides.
  • Avoid creams, lotions, or powders before putting your brace on. These soften the skin and may allow skin breakdown to occur.

Knight-Taylor Type TLSO

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The Taylor type orthosis is often prescribed for Anterior Compression Fractures or in cases where a person’s torso tends to lean forward. It consists of a padded rigid frame that lies against the back of the torso from the pelvis to the shoulder blades and a cloth front that holds the lower frame to the body. Front shoulder straps hold the upper back against the frame. Some designs may also include a chest pad.

Application

  1. Loosen the straps to make application easier.TLSO (Thoracic Lumbar Sacral Orthosis)
  2. Insert one arm through the top strap, as you would apply a shirt. Once in place, insert the other arm.
  3. Align the frame around the pelvis with the lower aspect of the corset front sitting at the top of the pubic bone.
  4. Tighten the straps around the pelvic section.
  5. Tighten the shoulder straps so that the shoulders are held firmly against the back frame of the orthosis.

Use and Care

The cloth front can be removed for cleaning. This should be hand washed in a mild detergent, rinsed well, and air-dried. If the back frame is covered with leather, it can be wiped with a damp cloth to clean. The leather should not be soaked as it may become brittle and crack.