Custom TLSO (Thoracic Lumbo Sacral Orthosis & LSO (Lumbo-Sacral Orthosis)

After your physician has ordered a custom LSO or TLSO, please call our office at 513-281-2800 as soon as possible for an evaluation and measurement appointment. Below is an explanation of our process and what you can expect:

1. Call to schedule your first appointment as soon as your doctor prescribes the orthosis. If you know when the surgery date is, please let us know at that time. Ideally, we prefer no less than 4 weeks prior to surgery. This will give you time to get used to the orthosis. Your first appointment will take about 1 to 1 ½ hours.

2. When you arrive, please present our staff the written prescription, photo ID, and insurance cards. You will be asked to fill out some paperwork.

3. You will be evaluated by one of our practitioners who will explain the casting and fabricating process.

4. For the casting, you will be asked to remove your outer clothing and put on 2 layers of stockingnette. This material is a stretch type cotton material that is similar to a tube sock with arm holes that will slip over your body. We ask that our female patients wear a bra during this procedure. Our staff will help you if necessary.

5. Our practitioners will identify landmarks and take a few measurements. We will then apply a plaster cast to your torso as you stand holding on to parallel bars if needed. If you are receiving an LSO, we will cast from your hips to just below the breast line. A TLSO is casted to above the breast. The cast will be removed after it hardens. The actual casting takes approximately 10 minutes and the cast becomes warm as it hardens. As the cast is removed, one of the stockinette layers sticks to the plaster mold, the other stays on you.

6. When the casting is complete, you will be asked to set a fitting appointment, usually about 7-10 days later, and a follow up appointment the day before your surgery. At the fitting appointment you should bring or wear a well fitting undershirt (not too tight or too loose) again we ask that our female patients wear a bra during this procedure. This appointment can take 30 minutes to an hour, depending on any adjustments necessary for proper fit.

7. The time between the fitting and the follow up before surgery is for you to get used to your orthosis and learn how to manage with it. One of our goals it to have you wear the orthosis full time comfortably and without issues before your surgery. If any adjustments are needed, we can make those adjustments and still have time to make sure all is well with the orthosis. It is common that you will have some pain relief as you wear the orthosis more and more.

The orthosis is made from a thin plastic material with soft padding throughout. The front overlaps the back section and there are 2 Velcro straps on each side. The most common color combination is white plastic with beige straps. We have a few other color options available.

The front (anterior) top edge ends just below the breasts and the bottom is cut up as to not rub when sitting.  The back (posterior) top section is trimmed just below the scapulae and at the bottom at the sacrococcygeal junction or gluteal fold (low enough to support you but not hit the seat of the chair when you sit).

The orthosis is usually made for the front to overlap the back section with 2 straps on each side. Of course, we can make the overlap either way and use as many straps as necessary for proper function.

For a Thoracic Lumbar Sacral Orthosis (TLSO), the same procedures are followed as above but the cast and orthosis is above the breast line and the back (posterior) top section is trimmed just above the scapulae. The orthosis usually has 3 straps on each side and the shoulder straps are an option depending on your procedure and the physician's order.

The orthosis can be perforated if it causes you to perspire excessively or make you feel too hot. Always wear a T-shirt under your orthosis, never on bare skin, as this may cause skin irritation and breakdown.

Cleaning is easy; just wipe it out with an alcohol wipe, damp cloth or soap and water. Never immerse the orthosis and air dry - do not use heat to dry it. Avoid getting the Velcro straps wet; they take a long time to dry.
The average post operative patient wears the orthosis for about 3 months and not when in bed or bathing. Of course, your physician will have specific instructions for you.
If you are wearing any of our orthoses and are having any issues, problems or have a question, never hesitate to call our office. We want your device to be functional AND as comfortable as possible. 


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Walnut Hills Office
   2375 Florence Ave.
    Cincinnati, OH  45206
Phone:      513-281-2800
Toll Free:  888-281-1007
Fax:         513-281-0420

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