A Patient's Guide to Thoracic Lumbar Sacral Orthosis T.L.S.O

Your Orthosis (TLSO) has been designed to:

• Optimise the alignment of the spine and pelvis and correct Scoliosis/ Kyphosis alignment when appropriate.

Every new orthosis is individually made to your requirements. It may alter the way you balance and move. We expect that this will take you some time to become acclimatised to. While we make every effort to ensure that your orthosis is safe and effective for you to use, you will need to gradually build up the length of time your TLSO is worn to ensure that it will not cause skin damage.

Your skin should be regularly inspected especially during the first few days. Reddening is normal, especially where the corrective pads (if any) are situated. The skin will gradually build up a resistance to these pressures – this is why it is important to have a gradual build up of wearing time.

When applying the TLSO ensure that the waist of the TLSO aligns correctly with the body’s waist and that the brace is sufficiently tight to be effective.

It is vital that in combination with applying the TLSO tightly it must be worn for the full recommended wearing regime. This will be recommended by the prescribing Orthotist/medical consultant and is fundamental in achieving a successful outcome.

It is most important to adhere to the wearing regime and to keep the regular appointments with your doctor and Orthotist. Continuity of care is vital. If you think you are growing out of your brace please contact the orthotics department immediately for it to be reviewed.

The TLSO can be removed for contact sports and exercises that require freedom of movement. Also please note:

• Do not carry heavy loads
• Do not use a trampoline
• If unable to wear the TLSO throughout the day in hot climates do continue to wear at night.

Any sensation of abnormal movements within the orthosis should be immediately reported to your Orthotist, and checked, to ensure prevention of joint or material failure.

Simply requires the inside surfaces to be wiped daily using a moist cloth, with mild disinfectant and warm water.

Do

• Take a moment to inspect the orthosis before each use – check for sharp edges, loose components or foreign objects on/inside the orthosis which could injure you
• Inspect the skin visually before and after every use, using a mirror if necessary. If you have problems carrying this out due to poor eyesight or mobility ask someone to help you
• Use fabric interfaces e.g. a sock or Tubigrip as directed to help protect you from friction
• Clean your orthosis with warm soapy water and allow it to dry naturally
• Observe good skin care and hygiene measures.

Do not

• Pad your orthosis out yourself as this may actually increase pressure problems
• Heat, glue, bend or otherwise attempt alteration or repairs
• Use strong solvents to clean the orthosis
• Use a heat source to dry the orthosis e.g. radiator or hair dryer as this could damage the device
• Artificially try to harden your skin e.g. by applying alcohol to the skin.

• If any discomfort, pain or skin marks appear that do not readily resolve (in around 20mins).
• If any cracks are noticed, or padding is worn out
• If you grow and the device becomes too small.

Once you have received the prescribed orthosis and we have reviewed your progress we may place you on “Supported Discharge”. In brief, this is when we will continue to refurbish your orthosis but you will require a new referral to be seen by an Orthotist.

Orthotist:

Orthotics Department
Royal National Orthopaedic Hospital
Stanmore
Middlesex
HA7 4LP

Tel: 0208 909 5418