Miami TLSO in the management of scoliosis: Preliminary results in 100 cases

A custom fabricated polypropylene thoraco-lumbo-sacral orthosis (TLSO) for the treatment of scoliotic curves with an apical vertebrae of T7 or below is described, and the results in 100 patients treated over a 5 year period are reported. The average follow-up for all cases was 13 months, the longest being 59 months. Average initial correction in brace for thoracic curves was 36%, for thoraco-lumbar curves 56%, and for lumbar curves 63%. Double major curves averaged 38% initial correction for the upper curves and 37% for the lower curves. Twenty cases had completed brace treatment with an average follow-up of 8 months out of brace. Of the 30 curves in the 20 patients, 11 were improved more than 5°, 19 remained unchanged (+5°), and none had progressed more than 5°. Twenty-three percent of the patients required a second orthosis and complications occurred in only two patients. The primary advantages of this TLSO include improved cosmesis, minimal discomfort, excellent provision for heat exchange, minimal confinement of the thoracic cage, and maximum retention of spinal mobility.