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.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.