TLSO Brace: Types, Indications and FAQs

The full-back orthosis or the TLSO brace is an orthotic treatment for a variety of spinal issues. 
Although these days the brace is rather common and you’ll see people of all ages wearing it, it’s still a bit daunting for first-time users who have several questions about it. 
If you’re new to TLSO then keep reading as we explore its types, indications, and other FAQs. By the end of this post, I trust that you’ll know all the basic information about this orthosis and that’ll make wearing the brace much easier for you. 
What is The TLSO Brace?
The Thoracic Lumbar Sacral Orthosis [TLSO] is a corrective brace that covers the entire back, from below the chin or the collar bone down to your pelvis. 
It’s made of a plastic material with foam and padding inside so that it’s comfortable to wear. The TLSO brace is fitted for your body and it applies pressure and provides stabilization to the back.
This brace is for the entire back but your Orthotist can prescribe the brace for specific segments of your spine as well. Such braces are named according to the regions they support. So the brace that only covers the thoracic spine [mid back] and the lumbar spine [low back] is called a Thoracic- Lumbar Brace [TLO]. 
There are several brace designs; some are one-piece with an opening on the front or the back while others are two-piece braces called clamp-shell style that come together by straps on the sides. 
TLSO Brace Types
The two main categories of this brace are off-the-shelf or prefabricated brace and custom TLSO brace. Your waist measurements are used to determine the size for the premade ones. And your Orthotist makes the custom brace based on a mold or exact measurements of your body. 
Here are some types of the spinal brace: 
1. Boston Brace 
The Boston brace is the most widely used TLSO brace for scoliosis patients today. It’s prefabricated and comes in many different sizes. The Orthotist matches the brace according to each patient's abnormal curvatures. 
2. Wilmington Brace
The Wilmington brace is a customized scoliosis brace. Its pressure points are designed according to the specific patient and it doesn’t have open slots or relief areas as seen in the Boston brace. 
3. Knight Taylor TLSO 
This brace is different from the other TLSO braces because it usually only has rigid support on the back while the front is a cloth-like material to hold the back frame tight. However, some variations of the Knight Taylor brace do come with chest support/pad. 
It’s used to stabilize fractures or injuries. 
Indications for Prescribing the TLSO Brace
The TLSO is mostly prescribed to fix lateral curvatures of the spine in Scoliosis. But it’s also used to correct postural issues, stabilize your back after an injury, surgery, or a degenerative condition.
Some of the TLSO brace indications include: 

1. Scoliosis. 
2. Anterior compression fractures or stabilized fractures of the vertebra.
3. Instability of the back to maintain upright posture due to osteoporosis or degenerated vertebral disks.
4. Postoperative stabilization and protection of the spine. 
5. Paraplegia [paralysis of the lower half of the body].

Common Questions About TLSO
Patients just beginning to use the TLSO have several questions about what they can expect down the line. Based on our experience with back brace clients, here’re some of the FAQs: 
1. How Long Should I Wear the TLSO Brace? 
The brace is worn for 18-23 hours a day. You have to keep it on while sitting, standing, and doing your daily activities. Some of the braces are required to be worn while laying in bed as well. 
Your Orthotist is the best person who can tell you the exact duration you have to wear it based on your condition. Most scoliotic patients wear it for several months to a year and a half.
2. How Can I Clean the TLSO Brace? 
The different parts of the brace are cleaned separately. You can wash the cloth straps with mild detergent and water, the plastic with mild soap and water, and clean the leather portion with a damp cloth. 
Don’t use strong cleaners or detergents on the brace. And always ensure it’s completely dry before putting it back on. 
3. Can I Wear the TLSO Brace While Exercising or Being Otherwise Physically Active? 
Yes, since you’ve got to wear the brace all day you can exercise with it as well. 
Each brace has some limitations that your doctor can tell you about. Generally, it’s recommended not to lift heavy weights more than five pounds or perform exercises that’ll make you excessively sweaty. 
4. How Much Does TLSO Cost? 
The TLSO brace cost is dependent on various factors such as materials used, customizations, and production company. An off-the-shelf brace can cost an average of $1000-2000 while a custom TLSO brace can be over $5,000. 
There are other costs involved in TLSO care such as screenings, lab tests, scans, and doctor’s office visits. 
Insurance plans do cover most of the cost. You should check with your insurance provider to get an estimate of how much will be covered in your case. 
5. How Will the TLSO Brace Affect My Skin? 
Some redness on the pressure areas is normal and it’s nothing to worry about as long as it’s resolved once you take the brace off and the region isn’t painful or tender. Wearing a T-shirt helps avoid friction between the brace and skin and it keeps the skin healthy by absorbing perspiration as well. 
You should contact your Orthotist in case of skin breakdown or if you develop a bruise because that’s an indication that your orthosis needs to be refitted. 

Find a TLSO Expert Near You You’ve got to remember several details and tips about cleaning, maintenance, donning, and doffing when using the TLSO brace so that you can fully benefit from it. For that, you need qualified Orthotists who can guide you through this challenging process. 
Book an appointment with our Orthotist or visit our clinic near you to get a brace fitted for your back.  Our multidisciplinary teams can answer all your questions and help you get started with the best TLSO for your needs!  

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