Cascade Orthotics Ltd.

Thoracolumbosacral Orthosis (TLSO)

TLSO Instructions [Version Française]

A TLSO is a rigid spinal Orthosis that spans the thoracic, lumbar and sacral spine. It is used to provide post-traumatic and post-surgical stabilization. A custom-made, rigid TLSO provides the maximum amount of exterior stabilization to the thoracic and lumbar parts of the spine.

The effective range of stabilization is from T5 – L4. An extension to the head with a cervical superstructure or to the leg with a hip joint and thigh cuff can increase the effective range of the TLSO through the entire length of the spine.

It is often custom-made from polyethylene plastic with a soft interface for patient comfort and can be either made in one piece with a single opening or in two pieces with lateral openings. The latter design is referred to as a clam-shell style. Of all the different designs the clam-shell is the easiest to apply. A custom-made TLSO is usually fabricated from a plaster of Paris cast or from digital scanning technology.

It is often used to provide non-operative management of:

  • burst-type fractures
  • multi-level compression fractures
  • Chance-type fractures
  • complex multi-planar fractures

Other indications include restriction of mobility for pain relief due to:

  • Osteomyelitis
  • Discitis
  • multi-level lesion for metastatic disease
  • Scoliosis
  • Scheuermann’s kyphosis
  • Ankylosing Spondylitis

The TLSO may also be used post-operatively to limit mobility of a region to enhance bony fusion. The duration of wear is typically up to 3 months depending on the treatment requirements of the Spine Surgeon.

Under certain circumstances, the cost or a portion of the cost of this device may be covered for residents of Alberta by government funding.


TLSO with hip extension