Name of the Procedure:

Thoracolumbosacral Orthosis (Tlso), Sagittal Control
Common Name: TLSO brace
Technical Term: TLso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding

Summary

This procedure involves fitting a patient with a TLSO brace that helps control the movement of the upper and lower spine. The brace has a rigid back frame and a soft front part with straps and padding for comfort and effectiveness. This orthopedic device restricts major trunk motion in the sagittal plane (front to back) and helps reduce pressure on the spinal discs.

Purpose

Medical Conditions Addressed:

• Spinal instability
• Post-surgical support
• Vertebral fractures
• Degenerative disc disease
• Scoliosis

Goals/Expected Outcomes:

• Reducing pain and discomfort
• Stabilizing the spine
• Promoting healing after surgery
• Improving posture and mobility
• Reducing load on intervertebral discs

Indications

Specific Symptoms or Conditions:

• Acute or chronic back pain due to instability
• Post-surgical stabilization
• Fractures in the thoracic or lumbar spine

Patient Criteria:

• Patients requiring sagittal plane control
• Those needing reduction in spinal disc pressure
• Individuals needing support for trunk motion restriction

Preparation

Pre-procedure Instructions:

• No special preparations like fasting are needed
• Patients may need a preliminary fitting session

Diagnostic Tests:

• X-rays or MRIs to assess spinal issues
• Initial physical examination

Procedure Description

1. Assessment: Initial assessment by an orthopedic specialist to determine suitability.
2. Fitting: Measurement and fitting session to customize the brace.
3. Instruction: Patient receives training on how to wear and adjust the TLSO brace.
4. Application: The brace is applied, starting with the rigid posterior frame, followed by wrapping the soft anterior apron and fastening the straps.
5. Adjustment: Final adjustments to ensure a snug fit without causing discomfort.

Tools/Equipment:

• Custom-fit TLSO brace with rigid and soft components
• Measuring tools for initial fitting

Anesthesia or Sedation: Not applicable

Duration

The fitting and adjustment procedure typically takes about 30 to 60 minutes.

Setting

The procedure is usually performed in an outpatient clinic or medical office specializing in orthopedics.

Personnel

• Orthopedic specialist or technician
• Possibly a nurse or medical assistant for support

Risks and Complications

Common Risks:

• Skin irritation
• Discomfort or chafing initially

Rare Complications:

• Pressure sores
• Allergic reaction to materials
• Improper fit causing increased pain

Benefits

Expected Benefits:

• Pain relief
• Proper spinal alignment

• Support for daily activities

  Realization Time: Benefits are usually felt immediately upon proper fitting, but optimal results may take a few weeks of continual use.

Recovery

Post-procedure Care:

• Regular monitoring for skin issues
• Instructions for daily wear and care of the brace

Recovery Time:

• Varies depending on the underlying condition, but generally, patients are immediately mobile

Restrictions:

• Patients should avoid activities that might cause strain on the spine

Follow-up:

• Regular follow-up appointments to adjust and monitor the brace

Alternatives

Other Treatment Options:

• Physical therapy
• Pain management (medications)
• Surgery (in severe cases)

Pros and Cons:

• Physical therapy may offer more active engagement but requires time
• Surgery is invasive with longer recovery but might be necessary for severe cases

Patient Experience

During the Procedure:

• Minimal discomfort during fitting

After the Procedure:

• Initial adjustment period with possible discomfort
• Pain management involves proper fit and possibly over-the-counter pain medication
• Patients generally resume daily activities with improved comfort and mobility