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Thoracolumbosacral Orthosis

Medically reviewed by Last updated on Jan 5, 2023.

What is a thoracolumbosacral orthosis (TLSO)?

A TLSO is a device used to support your spine and keep it from moving. A TLSO is made to fit from the middle of your chest to your tailbone. The TLSO provides support for your upper, middle, and lower spine at the same time. This is called a 3-point system. The 3 points are at your chest level, your ribs, and your pelvis. You may also need a piece that attaches to the top of the TLSO and fits under your chin. This prevents your head from moving. Examples of a TLSO include a clamshell brace and a thoracolumbar extension orthosis (often called a Jewett brace).

Why may I need a TLSO?

A TLSO may be needed to keep your spine stable after surgery. A TLSO may also be used instead of surgery to help correct spinal problems. An example is scoliosis (a curved spine) in adolescents. The TLSO will help your spine heal and protect it from injury. You may need to wear the TLSO for several months. Adolescents may need to wear the TLSO for a few years, until the end of puberty.

How do I safely use a TLSO?

  • Get your TLSO fitted by your healthcare provider. It is very important that your orthosis is the right size for you and that it fits properly. Your healthcare provider will help you choose a TLSO that is right for your injury or condition. You may need to get a TLSO that is custom fit for your body.
  • Wear your orthosis as directed. You may need to wear your orthosis during certain activities or all the time. For example, you may need to wear it during any activity that could injure your back. Check the fit of the orthosis often. If it does not fit properly or moves out of place, it could cause more injury.
  • Care for your orthosis. Inspect your orthosis often. Do not wear your orthosis if it is damaged or broken. Ask your healthcare provider how to care for and clean your orthosis.
  • Start to strengthen your lower back as directed. You may need to work with a physical therapist to strengthen your lower back by doing exercises. Ask how much physical activity is safe for you.

How do I care for my skin?

  • Always wear a clean, dry cotton shirt under your TLSO. The shirt will help absorb sweat and protect your skin. A small amount of powder may also help reduce the amount of moisture on the skin beneath the brace.
  • Check all areas of your skin beneath the brace every day. If you find red or irritated areas, check the position of your TLSO to make sure it is not too tight or too loose. If you have a rash, try changing your T-shirt more often. This can help if the rash is caused by heat, sweat, or laundry products.
  • Talk to your healthcare provider about showering. You may be able to take off the TLSO to shower. You also may be able to shower while you wear it. If you shower with the TLSO on, be sure to thoroughly dry the brace and the skin under it.

When should I seek immediate care?

  • You have severe back pain.
  • You have numbness, tingling, or weakness in your legs.
  • You have problems urinating or having a bowel movement.

When should I contact my healthcare provider?

  • Your back pain gets worse when you wear your brace.
  • Your skin is sore or raw after you wear your brace.
  • Your brace is damaged or broken.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.