What is the recommended location for the superior trim line of a TLSO?

The recommended location for the superior trim line of a Thoracic-Lumbar-Sacral Orthosis (TLSO) is generally placed 1 inch inferior to the scapular spines. This location is critical for several reasons.

First, positioning the trim line a bit below the scapular spines allows the orthosis to provide adequate support and restriction to the thoracic and lumbar spine without interfering with upper extremity mobility. When the trim line is correctly positioned, it helps to stabilize the spine and reduces motion, which is essential for healing and ensuring proper alignment during recovery from spinal conditions.

Moreover, placing the trim line too high, such as at the level of the sternal notch or superior to the xiphoid process, can result in discomfort and limit the patient's ability to perform everyday tasks, which may discourage compliance with wearing the orthosis. The correct placement also enhances the overall effectiveness of the orthosis by ensuring that forces are appropriately distributed across the torso and spine, thus facilitating better use of the device in clinical practice.

Therefore, considering these functional and anatomical aspects, positioning the superior trim line 1 inch inferior to the scapular spines is the most appropriate approach for optimizing the benefits of a TLSO.