TLSO (TORAKO-LUMBO-SAKRAL ORTEZ)

🇺🇸 TLSO (THORACO-LUMBAR-SACRAL ORTHOSIS) – Clinical Protocol

Indications

• Vertebral fractures (compression, burst)
• Postoperative stabilization
• Spinal deformities (scoliosis, kyphosis, hyperkyphosis)
• Spinal instability
• Post-traumatic spinal protection
• Degenerative spine conditions

Clinical Objectives

• Immobilization of the thoracic and lumbar spine
• Restriction of spinal motion (flexion, extension, rotation)
• Postural correction using the three-point pressure principle
• Pain control support
• Promotion of safe early mobilization
• Postoperative protection
• Reduction of spinal load during daily activities

Application Principles

• Patient-specific measurement and custom orthosis design
• Proper fit and alignment assessment
• Daily wear time: 6–23 hours (depending on indication)
• Gradual weaning protocol
• Routine clinical follow-up and imaging when indicated
• Monitoring of skin integrity and pressure areas
• Assessment of patient compliance

Complications

• Pressure ulcers
• Skin irritation
• Muscle atrophy (with prolonged use)
• Noncompliance
• Decreased comfort
• Respiratory restriction (especially with rigid orthoses)
• Biomechanical issues due to improper fit

Materials

• Thermoplastics: Polyethylene (PE), Polypropylene (PP)
• Padding: EVA (ethylene-vinyl acetate), polyurethane foam
• Fastening systems: Hook-and-loop (Velcro), nylon straps, buckles
• Metal components: Aluminum bars, steel reinforcements