Your brace has been given to you to protect and support your spine, neck and sternum (breastbone) by limiting movement.

Your doctor will tell you how many hours and for how long you need to wear your brace. It is important to wear the brace for this period.

You should wear your brace any time your spine is upright, as advised by your doctor.

You must always wear your brace over a close fitting cotton T-shirt or vest. You can also turn the T-shirt inside out to prevent irritation from the seams.

Your skin should be regularly inspected, especially during the first few days of wearing your brace. Any break in the surface of the skin or blisters should be reported to the Orthotics Department.

Your brace can be cleaned with a wet wipe or mixture of warm water and gentle soap and should be dried with paper towels or left to dry naturally – the lining will not absorb water so it is easily dried.

For advice on showering and bathing please speak to your spinal team.

When you eat you should move your fork up to your mouth, you must not attempt to move your head forward. If your head moves, your brace is not fitted adequately and will not be doing its job effectively. You may find that you will need some help at meal times.

A soft diet is advised as you get used to the brace. You must use a drinking straw to drink.

If you have any problems with your brace please contact the Orthotics Department.

Tel: 020 8909 5418
Email: rnoh.orthotics@nhs.net

  1. While lying flat on a bed, log roll to one side. For guidance on how many people need to assist you with turning, please follow your doctors instructions as detailed on the previous page. A carer should then apply the back section of the brace. It should be pushed downwards into the bed and under your side.
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  2. The brace is shaped in at the sides for your waist. Check this shaping is over your waist. Also check that the brace is close fitting over your shoulders.
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  3. Log roll back so you are lying flat on your back, inside the brace. Check the waist and shoulder position again and ensure that you are lying evenly in the brace by checking that the height of the sides of the brace is even on both sides.
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  4. If necessary, log roll to the opposite side and pull the back section of the brace further around to ensure the brace is on evenly, or pull the back section down if it was too high.
  5. Place on the front half of the brace so that the sides overlap the back section. Ensure your chin is inside the brace. Tightly fasten the Velcro shoulder straps. Loosely fasten all the side straps and buckles.
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  6. Tighten the side straps in pairs. Start by pulling the two middle ones, in line with the waist, at the same time. Then tighten the bottom two and then the top two. Check that all the straps are fully tightened. The brace should be tight so it is secure on you but shouldn’t impact on breathing or digestion.
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  7. Once the brace is on securely, log roll to one side, drop your legs over the side of the bed and push up with your arms to a seated position on the edge of the bed, you may need assistance with this. Your chin should be resting inside the brace and your head should be facing straight forward.

Your doctor has instructed that you can put your brace on in sitting. You will need the help of one person to put on your brace.

  1. Place the back section of the brace onto your back. The brace is shaped in at the sides for your waist. Check this shaping is over your waist. Also check that the brace is close fitting over your shoulders.
  2. Attach the front section so the sides overlap the back section.
  3. Fasten the Velcro shoulder straps and then the side straps, ensuring the straps are tightened evenly on both sides.
  4. Your chin should be resting inside the brace and your head should be facing straight forward.
    23-39_RNOH_Revision_22-116_Spinal_brace_extended_CTLSO_WEB-Release_Page_6_Image_0001.jpg 23-39_RNOH_Revision_22-116_Spinal_brace_extended_CTLSO_WEB-Release_Page_6_Image_0002.jpg

These spinal braces are designed to allow small changes in size and weight, however if your weight changes a lot or you feel the brace is not fitting well please contact the Orthotics department to have the brace reviewed.

CTLSO (Cervical Thoracic Lumbar Sacral Orthosis).png

RNOH ref: 23-39
Date of next review: August 2027

Printing of this document is only valid on the day printed, please refer to the website for most up to date information:

https://www.rnoh.nhs.uk/patients-and-visitors/patient-information-guides/ctlso-cervical-thoracic-lumbar-sacral-orthosis-patients-guide

Page last updated: 05 August 2025