Short for Thoraccic-Lumbar-Sacral Orthosis, aka a plastic back brace. The TLSO comes in two parts, which are strapped together by three velcro strips which run along each side.

The area protected by a TLSO is practically the entire torso and abdomen, running from just below the neck to the middle of the pelvis. Grooves are inserted to coincide with the wearer's iliac crest, to help stabilize the orthosis and provide a guide for assembly. The TLSO gives the wearer the appearance of a large, plastic turtle.

Although it provides plenty of protection and support for the healing back, and it is definitely an improvement over a cast (for all its size and strength, the device only weighs 2.5 kg) the orthosis is still an annoyance to wear. I had to wear this plastic shell during a humid Wisconsin summer, and the T-shirt I wore beneath was not a pretty sight to see when I took the brace off. Additionally, when I wore the brace, I was not flexible enough to wipe my own ass without a special tool, which I found somewhat embarrassing.

How to put on a TLSO, from a prone position

I wore a TLSO for 2 months following back surgery. I was allowed to take it off while I was sleeping. If you are confined to such a device, check with your doctor before attempting these methods yourself.

The two-person method

To be used the first few weeks after surgery.
  1. Log roll yourself onto your side.
  2. Have your assistant shove the back side of the brace into your back.
  3. Log roll back onto your back.
  4. Have your assistant adjust the back of the brace so that is properly aligned with your back.
  5. Put the front of the brace over your body.
  6. Fasten the middle straps, tightly
  7. Fasten the lower straps, tightly
  8. Fasten the upper straps, but leave them somewhat looser, so you can breathe.
  9. At this point, you may find that the middle and lower straps can be tightened further.
  10. Sit up and take on the day.

Doing it yourself

To be used when your doctor gives the go-ahead.
  1. Log roll yourself to the side of the bed, with your legs hanging out over the side.
  2. Keeping your back as straight as possible, ease up to a sitting position. If you let your legs be pulled down by gravity, you can use them as a lever for your body.
  3. If you were clever, when you took off the TLSO last night, you put the pieces in locations where you can easily reach down and grab them from your current position.
  4. Grab the back side and put it on your back.
  5. Grab the front side and put it on your front.
  6. Tighten as mentioned above.
  7. Lie back down on the bed and tighten some more, because what seems tight from a sitting position can actually be made tighter.
  8. Sit up and take on the day.

Cleaning your TLSO

Use a moist rag and hydrogen peroxide.