A TLSO (thoracic-lumbar-sacral orthosis) is a two-piece plastic spinal brace. It supports your spine, helps reduce pain, limits harmful movement, and helps your spine heal.
Wearing a TLSO
You received three T shirts to wear under the brace. You may also wear your own shirt if it fits snugly. The shirt protects your skin and absorbs sweat.
You may hand wash your T‑shirts and dry them on a towel or drying rack. You may also follow the package instructions. Wash and reuse the shirts.
Heading Home
Arrange for someone to drive you home. A seat that reclines is the best choice. Firm seats will prevent the back-bottom edge of your TLSO from being pushed upward by seat cushions. Bend at your hip and knees, not your back when getting into and out of a car, sitting or standing.
The TLSO waist groove must be placed low on your waist (the soft space on your side between your hipbone and your ribs). Close the straps evenly and snugly (you may need help). The marks on the straps are a guideline as to how tightly your brace should be fastened. If you can tighten the straps past the marked lines, do so. If the TLSO is “riding up” on you it is too loose. Lie down, move the TLSO to the correct place and tighten the straps again.
Your doctor will tell you when to wear your brace and for how long you will need to wear it.
Putting on Your TLSO
Scan the QR code or use the link below to watch a video about putting on your TLSO.
https://uwhealth-public.wistia.com/medias/2bv3tiu16e
The TLSO must fit snugly. A tight fit limits harmful motion in your back. You may feel discomfort when you move into positions you should avoid. This is expected.
Directions
Lie flat on your bed and keep your back straight.
Move to one side of the bed. Use your arms and legs to move your hips. A caregiver may pull the sheet under you to help.
Roll to the other side of the bed, almost onto your stomach. Roll like a log. Do not twist.
Bend both legs by sliding your heels toward your buttocks. Lower your knees and turn your hips and shoulders together.
Have your caregiver place the back section of the brace against your back.
Place the bottom of the back section at your tailbone.
Have your caregiver hold the back section in place.
Log roll onto your back while the caregiver keeps the brace from moving then place the front section of the brace on your chest.
Slide the front section inside the back section.
Tighten the straps. Fasten the middle straps first to hold the brace in place then tighten the top and bottom straps on both sides. Use the marks on the straps as a guide for tightness. Tighten past the marks if you can.
Check that the brace is straight and centered on your body.
Make sure the waist groove sits low on your waist. This is the soft space between your hip bone and ribs.
Sit up and stand only after the brace fits snugly and feels secure. If the brace rides up, it is too loose. Lie back down, move the brace to the correct spot, and tighten the straps again.
Removing Your TLSO
You will need help getting out of your brace. To remove your brace:
Lie down on your bed.
Open all straps on the brace.
Remove the front shell.
Have a caregiver roll you onto your side or stomach.
Have the caregiver remove the back shell.
Do not twist or bend your back while the TLSO is off.
Sleeping
Your doctor will tell you if you should wear the TLSO while sleeping. These instructions may change during treatment.
If you can remove the brace at night, put it on before getting up. If you need to get up to use the bathroom, it may be easier to sleep with the brace on.
Moving In and Out of Bed
Follow these steps to get in and out of bed without twisting or bending.
To get into your bed:
Log roll onto your side.
Drop your legs over the edge of the bed.
Push up with your arms into a sitting position.
To get out of your bed:
Sit on the edge of the bed.
Lower yourself onto your elbow and forearm.
Lift your legs onto the bed while staying on your side.
Log roll onto your back.
Bathing
If your doctor tells you to wear the TLSO while sitting or standing, you can take sponge baths in bed with the brace off. You may also shower with the brace on.
After a shower, lie down and sponge bathe the skin under the brace. Do not twist or bend your back while the brace is off.
After your skin and the inside of the TLSO are dry, put the TLSO on before sitting or standing. You may wear the TLSO with wet straps or dry them with a hair dryer set on low.
Cleaning Your TLSO
If your doctor tells you to wear the TLSO while sitting or standing, clean the inside of the TLSO while you are lying in bed.
To clean the outside of your brace:
Wipe outside with a damp or soapy cloth.
Dry the brace well.
Scrub the straps with a brush on the smooth Dacron side if needed.
Remove lint from the hook fasteners so they hold well.
Let the straps dry while you wear the TLSO.
To clean inside of your brace:
Remove the TLSO.
Wipe the inside with a damp cloth.
Use mild soap if needed.
Rinse off soap and dry the inside with a towel or a hair dryer set on low or cool.
Once a week, wipe the inside with rubbing alcohol. Do not use cornstarch. You may use talcum powder if you like.
While the TLSO is off, change your T‑shirt and dry any sweat from your skin. Make sure your skin is dry before putting it back on.
Transportation
Arrange for someone to drive you. A seat that reclines is the best choice. Firm seats will prevent the back-bottom edge of your brace from being pushed upward by seat cushions. Bend at your hip and knees, not your back when getting into and out of a car.
Activity Restrictions
You should be able to do many daily tasks on your own or with some help. You may need help or tools to dress, pick up items, or wipe after using the bathroom. An occupational therapist can teach safer ways to do daily tasks while wearing the brace.
Do not expect to move in all directions or sit in all chairs. The brace limits bending and may make you feel top‑heavy. Avoid bending to reach your feet or the floor. Bend at your knees and hips, not your waist. Do not lift more than 10 pounds.
Use handrails on stairs.
Skin
You should inspect your skin under the brace daily to check for any breakdown please call the Orthotics Clinic to have the brace adjusted.
Follow-up Visit
Your doctor will tell you when to wear your brace and for how long you will need to wear it.
If your brace needs adjusting or you notice skin breakdown or redness, call the Orthotics Clinic to schedule a visit.
When to Call
Call the clinic if you have:
Numbness
Tingling
Pain
Bowel or bladder issues
Been unable to move or do daily tasks.
Who to Call
If you have questions, please contact your provider through MyChart or call your provider listed in your After Visit Summary or After Hospital Care Plan. For a list of UW Health Clinics, visit www.uwhealth.org/.