Using your 2-Piece TLSO (Brace) at Home Trauma
A TLSO (Thoraco-Lumbo-Sacral Orthosis) is a two-piece plastic brace. It works like a body cast that can be removed.
Purpose of the TLSO
Your TLSO maintains control of your spinal posture, helps reduce pain, prevents further injury, and promotes healing.
Wearing your TLSO
Your TLSO must be worn tightly. It reduces and prevents harmful motion in your back. Do not move into uncomfortable positions. You should be able to do many normal activities by yourself or with a little help from caregivers or an assistive device. Ask your doctor for detailed guidelines and restrictions.
Planning for your trip home
You will need someone to drive you home from the hospital. Firm seats will prevent the back bottom edge of your TLSO being pushed upward by seat cushions. Bend at your hip and knees, but not your back when getting into and out of a vehicle, sitting or standing. A car with seats that recline is the best choice.
Taking off your TLSO
You must wear your TLSO as ordered by your doctor. You are going to need help getting in and out of it. To remove it: lie down, open the straps, and remove the front shell without bending or twisting your back. Someone must log roll you onto your side or stomach, then remove the back shell. Do not twist or bend your back while the TLSO is off.
Putting on your TLSO
You have been given 3 T-shirts to wear under the TLSO; you may alternate these. Put on your TLSO while still lying down. Log roll onto the back of the brace. Do not twist or bend! IMPORTANT: 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 the TLSO 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.
If your doctor has told you to wear your TLSO at all times when up, your bathing options are:
1. Have someone sponge bathe you while you lay flat in bed with brace off.
2. Shower with your TLSO brace on.
- Whether you shower or have a sponge bath, make sure someone cleans the inside of your brace while you lay flat in bed.
- You may choose to remove your T-shirt from under the brace before you shower. It may be difficult to remove when wet.
- After shower/sponge bath, make sure your skin is dry before reapplying your brace. Ask someone to dry your skin while you lay flat in bed.
- If the straps get wet, you may allow them to air-dry while your brace is on, or you may blow dry them.
You must not twist or bend when your brace is off. You must lie flat and log roll to turn.
If your doctor allows you to shower without the TLSO, remove it just before starting the water and put it on again as soon as you dry off. Be careful not to twist or bend your back while the TLSO is off. You must have your doctor’s permission to do this!
Sleeping in the TLSO
Your doctor will tell you if you should wear your TLSO while sleeping or lying down. Your doctor may change these instructions during your course of treatment based on changes in your condition. If you are allowed to remove the TLSO while sleeping, be sure to put it on before you get up. If you need to go to the bathroom during the night, it may be easier to keep the brace on.
Cleaning the outside of the TLSO
Wipe off the outside with a damp or soapy cloth, and then dry. The straps may be scrubbed with a brush on the smooth Dacron side. The straps can air dry while the TLSO is being worn. The hook fastener area will hold best if all the lint is removed.
Cleaning the inside of the TLSO
The TLSO is lined with waterproof closed cell foam. When you take your TLSO off for your bath, someone else should wipe the inside with a damp cloth. If you prefer, you may also use a mild soap that you would use on your skin. Rinse the soap off the TLSO and dry the inside with a towel or a hair dryer set on “low” or “cool” before you put it on again. Once a week, wipe out the inside of the TLSO with rubbing alcohol. While the TLSO is off, change your T-shirt and dry any sweat from your skin so all places under the TLSO are dry. Do not use cornstarch on your skin. You may use medicated talcum powder if you’d like.
Your TLSO will make it hard to bend over and also make you more top-heavy than usual. Avoid bending over to reach your feet or the floor. Bend at the knees and hips, not the waist. You may need help or special tools to dress, pick things up from the floor, or wipe after going to the bathroom. An Occupational Therapist can provide tools and teach you new ways to do things while wearing your TLSO. Be careful on stairs and use handrails.
How long do I need to wear the TLSO?
Your doctor will decide how long you need to wear your TLSO. You must be sure to follow your doctor’s advice even if you feel better and would like to stop wearing it sooner. Your doctor will be checking your progress and will decide what is in your best long-term interest.
What should I do if my neurological symptoms get worse?
If you have more numbness, tingling, pain or are less able to move or do daily activities, call:
Patients of the Neurosurgery Clinic: (608) 263-1410
Patients of the Orthopedic Rehabilitation Spine Clinic: (608) 265-3207
After hours, nights, weekends, and holidays, this will give you the paging operator. Ask for the resident on call for your clinic. Leave your name and phone number with the area code. The doctor will call you back.
If you live out of the area, please call 1-800-323-8942 and ask for your clinic.
Call 911 if you experience sudden onset of weakness, or loss of bowel or bladder control.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 12/04/2008
Copyright © 10/22/2008 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6821
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