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Thoracic Lumbar Sacral Orthosis (TLSO) Bracing Tips and Care

Patient Marlo wearing TLSO brace


Purpose of the TLSO Brace

Scoliosis is a curvature of the spine. A child's curve typically progresses as they grow, so the goal of the brace your child was prescribed, is to prevent further curvature and ultimately correct the curve.

Putting On the Brace

The brace needs to be put on your child correctly for the brace to function properly. Make sure that the indention for the waist area is sitting above the top of the hip bone. You can then tighten down the straps to the mark made by your orthotist. It is fine to slowly work up to the marks over the first 3–5 days of bracing. One shoulder may be elevated in the brace.

Brace Wear Time

Your physician and orthotist will provide an exact number of recommended hours that your child needs to wear the brace each day. This number is based on many factors, including the size and location of the curve, and the age of your child. Most braces are either nighttime wear or 18–22 hours per day.

For nighttime wear, no build-up time is needed, but understand that it may take 3–5 nights to acclimate to wearing the brace through the night. Your child can start wearing the brace every night while sleeping. For full-time bracing, you will slowly work up to the 18–22 hours per day over the first week.

Here is an example of slowly increasing the wear time:

Day 1: 2 hours (AM) and 2 hours (after school)

Day 2: 3 hours (AM) and 3 hours (after school)

Day 3: 4 hours (AM) and 4 hours (after school)

Day 4: 5–6 hours daytime and sleep in the brace

Day 5: 6–7 hours daytime and sleep in the brace

You can continue to slowly increase wear to the prescribed wear time and adjust the schedule based on how well your child tolerates bracing. It is fine to increase the wear time a little slower than above. Just make sure your child is in the brace full time within 5–10 days of receiving the brace.

What To Watch For

You will want to check your child’s skin for redness after taking the brace off. Redness is completely normal with scoliosis bracing. You will see broad red areas where we are pushing on the curve. Make sure all other redness fades within 20–30 minutes after taking the brace off. The areas where we are pushing may have some skin discoloration, but this will go away once bracing is complete. Please contact the orthotics department with any of the following issues: blisters, calluses, or skin breakdown. These are all problems that need to be addressed.

Cleaning the Brace

Clean the brace weekly with rubbing alcohol or soap and water – wiping down the inside and outside of the brace. Clean the padding as well as the plastic.

Important Reminder

Please remove the brace for 24 hours prior to an appointment with the doctor for the out-of-brace X-ray. This excludes your first follow-up when the in-brace X-ray is taken.

Next Steps

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