Discharge Instructions: Using a Thoracolumbar Sacral Orthosis Brace (TLSO)

Your healthcare provider has prescribed a thoracolumbar sacral orthosis brace (TLSO) for you. A TLSO is a back brace. It's used to keep your back straight after surgery to help treat scoliosis or a spine fracture. Using the TLSO correctly will help you move on your own.

General guidelines

  • Wear a T-shirt under the brace. This is to protect your skin and absorb sweat.

  • Wear your brace as directed by your healthcare provider. They will tell you how often and how long to wear the brace each day.

  • Ask your healthcare provider for a special brace to wear in the shower.

  • Ask if you need to wear the brace at night.

  • Put on the brace the way you were shown in the hospital. You will need help to do this safely.

  • Check for skin irritation and reddened areas or pressure points (sores) after wearing the brace. If these appear, you may need to have your brace adjusted, or you may need a different size.

Putting on your brace

  • Move to one side of the bed by using your arms and legs to move your hips over. Or have a helper pull the sheet under you over to one side. Don’t twist or move your back. Keep it straight.

  • Roll to your side, away from the edge of the bed and almost onto your stomach. Try to keep your back straight. Roll like a log.

  • Put the back half of the brace on your back. Make sure the waist indentations on the inside of the brace are just above your hip bones and below your ribs.

  • Hold the brace in place and log-roll onto your back.

  • Put on the front half of the brace. Fully tighten both straps at the bottom of the brace on both sides. Then fully tighten the straps at the top of the brace on both sides.

  • Before getting up, make sure that the brace is aligned. Adjust it if needed.

  • Drop your legs over the side of the bed. Push yourself up to a sitting position. Then slowly raise yourself to a standing position.

Moving safely

  • Keep in mind that the brace will limit your ability to move in certain directions. You will not be able to sit in some types of chairs.

  • Use a cane, crutches, walker, handrails, or someone to help you until your balance, flexibility, and strength have improved.

  • Arrange your household to keep the items you need handy. Keep everything else out of the way.

  • Keep your hands free by using a belt bag, apron, or pockets to carry things.

  • Be careful when getting out of bed. Take your time. Sit on the edge of the bed. Take a few deep breaths. Don’t stand until any dizziness goes away.

  • Don’t bend or twist at the waist.

  • Don't raise your hands over your head.

  • Don’t lift anything heavier than 5 pounds for the first 2 weeks after your injury or surgery.

  • Don’t sit for longer than 30 minutes at a time.

  • Don’t sit on low, deep couches. A chair with arms, a firm seat, and an upright back is best.

Follow-up care

Follow up with your healthcare provider, or as advised. Keep appointments for X-rays. You will need repeated X-rays to check the status of your injury or surgical repair.

Call 911

Call 911 right away if you have any of these:

  • Sudden or worse shortness of breath

  • Sudden chest or back pain or chest pain with coughing

  • Calf pain, soreness, or swelling

Online Medical Reviewer: Luc Jasmin MD
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Online Medical Reviewer: Rita Sather RN
Date Last Reviewed: 2/1/2022
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