Using your CTLSO (Spinal Brace) at Home
What is a CTLSO?
A CTLSO (Cervical-Thoracolumbosacral
Orthosis) is a two-piece plastic brace with a
metal cervical attachment. It works like a
body cast that can be removed.
Your CTLSO must be worn tightly. It
should reduce or prevent harmful motion in
your back and neck. It should be
uncomfortable when you begin moving into
positions you should avoid. You should be
able to do many normal activities by
yourself or with a little help from caregivers
or an assistive device. Ask your doctor for
detailed guidelines and restrictions.
Planning for your trip home
Arrange for someone to drive you home.
Firm seats will prevent the back bottom
edge of your TLSO being pushed upward by
seat cushions. Bend at your hip and knees,
but not your back when getting into and out
of a vehicle, sitting or standing. A car with
seats that recline is the best choice.
Taking off your CTLSO
You must wear your CTLSO as ordered by
your doctor. You are going to need help
getting in and out of it. To remove it, lie
down, open the straps, and remove the front
shell. Someone must log roll you onto your
side or stomach, then remove the back shell.
Be careful not to twist or bend your back or
neck while the CTLSO is off.
Putting on your CTLSO
You have been given 3 T-shirts to wear
under the CTLSO. Wash and reuse the T-
shirts. They can be hand-washed and dried
on a towel or drying rack, or see the
instructions in the package. You will need
someone to help you don the brace and must
do it lying down. IMPORTANT: The
CTLSO waist groove must be placed low
on your waist (the soft space on your side
between your hipbone and your ribs).
Close the straps evenly and snugly (you may
need help). The marks on the straps are a
guideline as to how tightly the CTLSO
should be fastened. If you can tighten the
straps past the marked lines, do so. If the
CTLSO is “riding up” on you it is too loose.
Lie down, move the CTLSO to the correct
place and tighten the straps again. Your
doctor will tell you when to wear your brace
during the day and for how long to wear it.
Always wear a T-shirt under the brace to
provide a barrier between your skin and the
plastic and to absorb perspiration.
1. Move to one side of the bed by: -Using
your arms and legs to move your hips over
or - Having a caregiver pull the sheet under
you over to one side.
2. Roll to the opposite side of the bed almost
onto your stomach. -Bend both legs by
sliding your heels toward your buttocks -
Lower your knees and turn your hips and
shoulders. Do not twist! Roll like a log.
3. The caregiver should position the back
half of the brace. Making sure the waist
indentations on the inside of the brace are
just above the hip bones and below the ribs.
The bottom of the brace should be
positioned at your coccyx (tailbone).
4. With the caregiver holding the brace in
place, log roll onto your back.
5. Position the front half of the brace – First,
tighten the middle straps on both sides of the
brace, then fully tighten both straps at
bottom of brace on both sides. -Fully tighten
the straps at the top of the brace on both
sides, and retighten the middle straps as
needed. Check to see that the brace is
aligned before getting up and adjust if
6. Tighten straps from posterior head piece
to chin piece so they are snug but not overly
tight. If brace also has shoulder straps,
tighten for snug fit when standing. Both
neck and shoulder straps will be loose when
lying or sitting.
7. The chin piece will be much lower than
the chin when lying flat on back but will
get closer to chin as you incline. When
sitting at 90 degrees or standing, the chin
section should be up against the chin and the
head section against back of head.
Getting out of bed
Log roll onto your side. Drop your legs over
the side of the bed and push yourself up to a
Getting into bed
Sit on the side of the bed and lean down on
your elbow and forearm. Lift your legs up
onto the bed, staying in the side lying
position. Log roll from your side onto your
If your doctor has told you to wear your
CTLSO at all times when standing or sitting,
you may have sponge baths with the brace
off while lying in bed or take showers while
wearing the CTLSO. In both cases, clean the
inside of the CTLSO while you are lying on
your bed. If you shower, you should lie on
the bed when you are done and sponge bathe
the area under the brace. Be careful not to
twist or bend your back while the CTLSO is
off. After your skin and the inside of the
CTLSO are both dry, put the CTLSO on
again before sitting or standing. You can
wear the CTLSO with wet straps or dry
them with a hair dryer set on low.
Sleeping in the CTLSO
Your doctor will tell you if you should wear
your CTLSO while sleeping or lying down.
Your doctor may change these instructions
during your course of treatment based on
changes in your condition. If you are
allowed to remove the CTLSO while
sleeping, be sure to put it on before you get
up. If you need to go to the bathroom during
the night, it may be easier to keep the brace
Cleaning the outside of the CTLSO
Wipe off the outside with a damp or soapy
cloth, and then dry. The straps may be
scrubbed with a brush on the smooth Dacron
side. They can air dry while the CTLSO is
being worn. The hook fastener area will hold
best if all the lint is removed.
Cleaning the inside of the CTLSO
The CTLSO is lined with waterproof closed
cell foam. When you take your CTLSO off
for your bath, wipe the inside with a damp
cloth. If you prefer, you may also use a mild
soap that you would use on your skin. Rinse
the soap off the CTLSO and dry the inside
with a towel or a hair dryer set on “low” or
“cool” before you put it on again. Once a
week, wipe out the inside of the CTLSO
with rubbing alcohol. While the CTLSO is
off, change your T-shirt and dry any sweat
from your skin so all places under the
CTLSO are dry. Do not use cornstarch on
your skin. You may use medicated talcum
powder if you like.
Your CTLSO will make it hard to bend over
and also make you more top-heavy than
usual. Avoid bending over to reach your feet
or the floor. Bend at the knees and hips, not
the waist. You may need help or special
tools to dress, pick things up from the floor,
or wipe after going to the bathroom. An
Occupational Therapist can provide tools
and teach you new ways to do things while
wearing your CTLSO. Be careful on stairs
and use handrails.
How long do I need to wear the CTLSO?
Your doctor will decide how long you need
to wear your CTLSO. You must be sure to
follow your doctor’s advice even if you feel
better and would like to stop wearing it
sooner. Your doctor will be checking your
progress and will decide what is in your best
Things to Remember
Do not expect to be able to move in all
directions or sit in all types of chairs. The
brace is designed to limit certain motions
If you have localized redness, call your
orthotist so they can make changes to your
brace. Redness over a large area of skin and
pink in color is usually normal.
What do I do if CTLSO if not fitting right or
Patients should call the Orthotics Clinic
at (608) 263-0583 to schedule an
appointment for adjustments.
What should I do if my neurological
symptoms get worse?
If you have more numbness, tingling, pain
or are less able to move or do daily
Patients of the Neurosurgery Clinic:
Patients of the Orthopedic Spine Clinic:
After hours, nights, weekends, and holidays,
this will give you the paging operator. Ask
for the resident on call for your clinic. Leave
your name and phone number with the area
code. The doctor will call you back.
If you need adjustments to your CTLSO due
to sore areas or discomfort please call:
UW Health Orthotics Clinic:
(608) 263-0583 or (877) 894-9940
Your health care team may have given you
this information as part of your care. If so,
please use it and call if you have any
questions. If this information was not given
to you as part of your care, please check
with your doctor. This is not medical advice.
This is not to be used for diagnosis or
treatment of any medical condition. Because
each person’s health needs are different, you
should talk with your doctor or others on
your health care team when using this
information. If you have an emergency,
please call 911.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©2/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#7404.