Follow up re: TLSO scoliosis brace and carseat

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cande

New member

• Jun 29, 2011

• #1

I posted a few weeks back about my 4 1/2 dd and bracing for scoliosis.

Any one have any experience with a TLSO or "Boston-type" brace? (its molded to her body - not metal.) DDs arrives in about 2 weeks. I have concerns about whether her GN will be OK. We also use the Evenflo Chase as her school bus seat, and wonder if this is still OK as it is smaller and narrower (and thinking the brace will put her close to or over the 40# weight limit - she is 36 1/2#). The Orthotist and the Orthopedic PA both said she can still use standard car seats.

TIA

 

safeinthecar

Moderator - CPS Technician

• Jun 29, 2011

• #2

I would be more comfortable with a child in a true boston than a TSLO "boston type". The actual Boston brace has a panel in front that allows some forward flex at the waist. TSLO does not. I'm not sure what would happen in a crash with the truck of the body being kept ridged. I worry about the brace causing a pivot point and injuring the spine where it meets the brace (especially so for collarbone height or neck supporting braces), and the brace cutting down on the thighs as the shoulders roll forward above the brace and push it downward. I would rather see a child in a brace rfing if possible. I actually worked with a family several years back to import a car seat that would allow their son to rear face in while he went through a serious of progressively less restraining braces as he healed from spinal surgery.

Ask your Dr if it would be an option to cut down on car rides as much as possible and remove the brace in the car.

ETA: I've sent out some emails to a few people I know that are involved with studying car seats and special needs situations asking if they have done any crash testing on braces or casts of a similar height. I'll let you know if I get any additional info.

 

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cande

New member

• Jun 29, 2011

• #3

Thanks so much. It's a TLSO not a TSLO. (I do believe these are two distinct type of brace). It will be molded
Plastic type thing that will cover her torso. (think close fitting turtle shell) Her ped ortho (who is one of the tops in the field) is pretty adamant about 23/7. If there were any articles out there it might help move the conversation along. Thanks so much

ETA - here is a link to the type of brace, hers will be porpotionally smaller as the link shows one for a teenager.

http://scanscoliosis.com/

 

Last edited: Jun 29, 2011

safeinthecar

Moderator - CPS Technician

• Jun 30, 2011

• #4

cande said:

Thanks so much. It's a TLSO not a TSLO. (I do believe these are two distinct type of brace). It will be molded
Plastic type thing that will cover her torso. (think close fitting turtle shell) Her ped ortho (who is one of the tops in the field) is pretty adamant about 23/7. If there were any articles out there it might help move the conversation along. Thanks so much

ETA - here is a link to the type of brace, hers will be porpotionally smaller as the link shows one for a teenager.

http://scanscoliosis.com/

Click to expand...

23/7 is the standard pretty much from what I can tell. I was kinda thinking along the lines of if you could could maybe cut car rides down to the point where she was in them for less than her 1hr off time a day. Maybe even if you went over by 20mins one day, make up for it the next. I was looking at the correct brace BTW, I just can't type it correctly, .

 

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cande

New member

• Jun 30, 2011

• #5

Thanks - the logistics would be a be a bit nutty. I drive her to\from daycare in the a.m and at teh end of the work day, (20 min each way) then she is in a small school bus to\from her Special Needs Pre-K class in the middle of the day, then there are the couple of trips per week to speech therapy in the late afternoons. So getting her completely undressed\redressed each time doesn't seem pragmatic, she would have to cooperate, the undershirt would have to be pefect each time to prevent rubbing\sores, etc.

So, you're thinking there is no seat that is appropriate, rather than a seat different from what I have. Yikes. That didnt cross my mind.

 

safeinthecar

Moderator - CPS Technician

• Jun 30, 2011

• #6

cande said:

So, you're thinking there is no seat that is appropriate, rather than a seat different from what I have. Yikes. That didnt cross my mind.

Click to expand...

Well, special needs is a gray area. If the best you can manage is to make sure you have the harness on the proper slot, which may be different due to changes in her seating posture with the brace, and the harness is snug, and the car seat installed properly, then that is an appropriate option. That doesn't mean there are not risks involved, that just means that is the best protection that it is in your ability to provide.

I think the chase is out due to weight, but you already knew that. Personally, *I* would like to see her rfing, but the only thing you could rf her in is a Radian. There are a couple of Radians on the swap forum for really cheap if you think you might want to go that route.

 

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cande

New member

• Jul 2, 2011

• #7

Thanks for the analysis and conversation, it is keeping my mind off of some other issues related to her condition. So, here's my next thought(s) - how long could I reallly rf her, even in a Radian. She is 40" tall (actually once her spine is straightened out by the brace who knows how tall she would be...) and all torso. She will likey wear the brace for the next 5 to 8 years, until she is old enough for spinal fusion surgery. In my prior post, someone thought she needed a SN seat, but sounds like it wouldnt be much different proctection-wise than her GN for now?

Also stuck as to what to do for the school bus. I think our school district has very, very,very few buses with intergrated seats. More the older kids with behavioral issues and the like. They make the bus drivers install \ uninstall for each trip and the teachers and aides lug the seats from the curb all the way to the classroom. Crazy, but it is what they do. But they make all Pre-K kids be in a 5 point...

 

Last edited: Jul 2, 2011

ketchupqueen

CPST and ketchup snob

Staff member

• Jul 2, 2011

• #8

I might call EZ on and see about a harness for the bus...

Are you in LAUSD? I'm somewhat familiar with SN seating options for buses, having had the SN course, and I have some LAUSD special ed preschool teacher friends who might be able to brainstorm ideas with me, if you want.

 

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cande

New member

• Jul 2, 2011

• #9

We are in PUSD, and they have a contract with a transportation company (First Student). Most of the buses I have seen dd placed in have lap belts only. Thanks, I will check into EZ on (or do you have a contact?)

KQ, that would be great if you could get some ideas. DDs SN teachers dont have any ideas because they don't deal with it, other than to lug seats around. I may call dds admin person and just make them change her to one of the few buses, but I dont want her riding with 7th graders...

 

Jennifer mom to my 7

Well-known member

• Jul 2, 2011

• #10

On the rear facing issue, my 4.5 year old is still rear facing in a radian xtsl, at 41+ inches, 40+ pounds, needs 5T shirts, 4-5 pants, and has about 2 inches or so of shell over his head.

 

ketchupqueen

CPST and ketchup snob

Staff member

• Jul 2, 2011

• #11

Call EZ-On and explain her needs and that it's a bus with lap belts only. They will be able to help you figure out what you might use. I'll ask for any other ideas!

 

safeinthecar

Moderator - CPS Technician

• Jul 2, 2011

• #12

Here's an idea, the Ride Safe Travel Vest might be a good option since distributes crash forces across the entire torso. That way her upper chest above the brace will have a bit more support.

 

violets_mommy

New member

• Jul 4, 2011

• #13

I have no advice, just wanted to give hugs. I have had three spinal fusion surgeries and have 3 rods in my back as well since I was 13. I had to wear a TLSO brace for 8 weeks after my second surgery.

 

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cande

New member

• Jul 11, 2011

• #14

Casie: thanks so much for your note, it was very kind. We are investigating whether there is something causing her scoliosis or whether it is simply "idiopathic" But, regardlss she will be wearing teh TLSO for quite some time.

Left a message with teh school transportation director to talk about transport options, including perhaps the SD providing the EX-On vest (if it will work.

I have been toying with buying the RSTV anyways for vacations, etc. so that could be a great option. Is the RSTV difficult for daily use?

Once again, thank you for your advice and ideas.

 

ketchupqueen

CPST and ketchup snob

Staff member

• Jul 11, 2011

• #15

It's not so much "difficult" as "a little bit more time consuming."