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

Your doctor has prescribed a thoracolumbar sacral orthosis brace—or TLSO—for you. A TLSO is a back brace. It is used to keep your back straight after surgery. Using the TLSO correctly will help you move on your own after surgery.

General guidelines

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

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

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

  • Apply 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 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 by having 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.

  • Have the person helping you position the back half of the brace on your back, making 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.

  • Position the front half of the brace. Fully tighten both straps at the bottom of the brace on both sides. 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 necessary.

  • Drop your legs over the side of the bed and 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 fanny pack, 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, and don’t stand until the dizziness goes away.

  • Don’t bend or twist at the waist, and don't raise your hands over your head.

  • Don’t lift anything heavier than 4 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. These will be needed at regular intervals to check the status of your injury or surgical repair.

Call 911

Call 911 right away if you have any of the following:

  • Sudden or increased shortness of breath

  • Sudden chest pain or localized chest pain with coughing

  • Calf pain, tenderness, or swelling