Suspension TLSO response summary

Suspension TLSO response summary

Linda And Ken

9/23/2011

I want to thank everyone who responded and those who offered further
guidance in voicemail messages, very much appreciated. Several people
pointed me to Fillaur for the parts and I have confirmed that they still
provide these, catalog info below, so I left out the messages that contain
only that information.
 
Here is my original post and the rest of the responses:
 
Hello all,
 
I have a request to do a suspension TLSO for a young patient with sacral
agenesis. It is my understanding that the TLSO would be part of a seating
system. I have seen photos at some point of a similar device with threaded
inserts that get pulled into the polymer near the waistline and round bar
stock that attaches to these and then to a base under the seat of the
wheelchair.
 
My question is: does anyone know of a source for these components? If so,
have you had any experience with using them or any tips for doing this sort
of thing. I imagine the biggest concern would be excessive pressure/
breakdown at the costal margin as a deep waist impression would be key for
unloading. Any advice would be appreciated and I'll be glad to post
results.
 
Thank you,
 
Ken Boggs CO
Rehabilitation Institute of Chicago
312-238-2832
 
 
I don't have photos, but we used to also make suspension jackets riveting
two stainless steel (Milwaukee uprights) to the back of TLSO with the tops
bent into hooks, and screwed on for height adjustability. Then we'd put a
stainless or aluminum bar across the back of the wheelchair at the top of
the seat that these hooks could drop onto as the patient was put in their
chair. It worked pretty well for our kids, I don't know how it would do for
adults. Also, you want to adjust so you're just taking some weight off, not
all, or you will get some major digging at the lower costal margin

Per your request see below or page 356 of the Fillauer catalog attached as a
.pdf
Thoracic Suspension Jacket (TSJ)
 
TSJ Components Kit
Part #099002
Includes:
A .099010 Aluminum Lug with 099093 Screw
(5/16-18x1-1/2) (3/16 Hex Key Provided)
B.099044 Clamp Assembly (5/32 Hex Key Provided)
C .099036 Hanger, Stainless Steel, Right and Left Pair with Vertical bend at
3-1/4
D .099037 Pe-LiteT Cup Assembly Includes A-20 Cup, Washer, and Adapter Nut
 
Optional SS Rod stock- to make custom bent hangers
099028 Hanger Rod, Stainless Steel, Right and Left Pair without Vertical
Bend (Not Pictured)
Supply item-
199547 Rapidcure, 1/4lb Kit, (Not Pictured) Used to Fill Pe-LiteT Cup and
Form Mounting Berm
 
 
101099 Buckle Loop, 24 Gauge Stainless Steel (for mounting rod to chair)
 
. Custom fabrication of orthoses Fabrication Tools For TSJ
 
A. 099077 Anchor Cup Alignment Rod
B. 099088 Casting Rod, (1/4)
C. 885863 Hex Key, 3/16
D. 885855 Hex Key, 5/32
 
 
Newington childrens hospital had a thoracic suspension jacket they used
for kids with varying diagnoses mostly Mylo I thought the system was
available through Fillauer. We did one several years ago here in the Tampa
Shriners hospital but back in the 80's we did quite a few at the Springfield
Shriners hospital. The jackets were foamed lined and made of Polyethelene
and suspended under the costal margin, the jacket was suspended from the
lateral wheel chair frame by hooks that attached to the chair frame and then
to the lateral sides of the jacket via the attachment kit.
I guess the question that comes to mind is the age of your patient? And what
the goals or expectations are.
 
 
Ken, I believe that Fillauer sold the parts. There was a published article
on the technique in either JPO or CPO. do a search on oandp.com 's link.
Terry
 
  I did several of these years ago and I would caution you about expecting a
good outcome. The only successful longtime user I had was a slender
patient, SCI I believe, who had very developed uppers and latissimus dorsi,
and was able to tolerate the pressure. Most patients with sacral decubitus
are overweight and you are expecting the rib cage to be a weightbearing
structure, which usually doesn't work so well. If you do attempt it you can
find the components at Fillauer, consisting of hooks mounted to the
wheelchair back, and a threaded insert that is molded into the tlso. A metal
spool shape screws into the insert after pulling the plastic, and the
patient, or their assistants, have to lift the patient up into the hooks to
capture the spool. The anterior/posterior, and proximal/distal location of
this is critical to the patient's balance, because if you mount this too far
anteriorly the patient will end up leaning back in the wheelchair, and will
have difficulty with propulsion. Most centers have given up on these
devices years ago as gel cushions and ROHO are much more effective Good
luck;
 
Hello,
 I have done a few of these for wound care, especially those with
paraplegia. The components can be ordered from Fillauer. They will also
central fab the tlso for you.
A few points to consider: You have to be able to get a tight squeeze
through the waist so if your patient has a high BMI or any ostomy sites, the
tlso will not hold them up and they will slide through the tlso.
There are hooks that mount to the wheel chair uprights so the chair needs to
have, I believe, 7/8 tube canes as fillauer's kit only has one size of
clamp.
This system will not completely un-weight a person and they do not remain in
the suspended position for more than 20-30 minutes to start with.
Fillauer has a fabrication and research study for this if you request it.
I hope this helps.
Good luck!
 
 
Friddles Orthopedic is a great source

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