BACK BRACING

ORDERING INFORMATION

BACK BRACES Waist Measurement Sizing

Model Part # Small (x = 2)Medium (x = 3)

Large (x = 4)

X-Large (x = 5)

XX-Large (x = 6)

XXX-Large (x =7)

TLSO 11-1585-x 30-35” in(76-89 cm)35-40”

(89-102 cm)40-45”

(102-114 cm)45-50”

(114-127 cm)50-55”

(127-140 cm) N/A

LSO W/CHAIRBACK (8”) 11-1562-x

25-30” in(64-76 cm)

30-35”(76-89 cm)

35-40”(89-102 cm)

40-45”(102-114 cm)

45-50”(114-127 cm)

50-55”(127-140 cm)

LSO PREMIUM PLUS 11-1576-x

25-30” in(64-76 cm)

30-35”(76-89 cm)

35-40”(89-102 cm)

40-45”(102-114 cm)

45-50”(114-127 cm) N/A

LO REGULAR (10”) 11-1568-x

25-30” in(64-76 cm)

30-35”(76-89 cm)

35-40”(89-102 cm)

40-45”(102-114 cm)

45-50”(114-127 cm)

50-55”(127-140 cm)

LO LOW PROFILE (8”) 11-1569-x

25-30” in(64-76 cm)

30-35”(76-89 cm)

35-40”(89-102 cm)

40-45”(102-114 cm)

45-50”(114-127 cm)

50-55”(127-140 cm)

LO LITE (9”) 11-1570-x

25-30” in(64-76 cm)

30-35”(76-89 cm)

35-40” (89-102 cm)

40-45”(102-114 cm)

45-50”(114-127 cm) N/A

SI BELT* 11-1571-x N/A 25-35”(64-89 cm)

35-55”(89-140 cm)

N/A N/A N/A

*The sizing for the SI Belt is measured off of the hip measurement 1” above the greater trochanter.

REPLACEMENT PARTS / ACCESSORIES Waist Measurement / Chairback Height

Model Part # Small (x = 2)Medium (x = 3)

Large (x = 4)

X-Large (x = 5)

STANDARD CHAIRBACK 11-1563-x 25-30”/13.0”(64-76/33 cm)30-35”/14.0”

(76-89/36 cm)35-40”/14.5”

(89-102/37 cm)40-55”/14.5”

(102-140/37 cm)

SHORT CHAIRBACK**The Short Chairback is designed for shorter torsos, so the frame is 13” in

height for all sizes.

11-1564-x N/A 30-35”/13.0”(76-89/33 cm)35-40”/13.0”

(89-102/33 cm)40-55”/13.0”

(102-140/33 cm)

7˚ LORDOTIC INSERT (pair) 11-1565Lordotic foam inserts fit easily into the posterior pockets of the DonJoy LSO Regular

and LSO Low Profile braces and are available in 7˚, 10˚ & 12˚ lordotic options.

Not for use with the DonJoy TLSO and DonJoy LSO Lite models.

10˚ LORDOTIC INSERT (pair) 11-1566

12˚ LORDOTIC INSERT (pair) 11-1567

TLSO STRAP KIT 25-1585-x 2 = Small 3 = Medium through XXLarge

S/M L

ANATOMICAL RANGE OF SPINAL SUPPORT

GENERAL INDICATIONS & RANGE OF SPINAL SUPPORT

Atlas (C1)Axis (C2)

C7T1

T12

T9

L1

Sacrum (S1–S5)

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DONJOY BACK BRACE PRODUCT LINE

DONJOY BACK BRACE PRODUCT LINE

S1–S5 L1–L5 L1–S1 L1–S1 T9–S1 T9–S1 T2/T3–S1

INDICATIONS FOR USE

Sacroiliac Pain Low Back Pain Low Back Sprains/Strains Lumbar Disc Displacement Osteoporosis Disc Herniation & Degeneration Post-Operative Laminectomy Post-Operative Disectomy IDET Procedure Spondylolisthesis Post-Operative Fusion Spinal Stenosis Compression Fractures Kyphosis Scoliosis

LSO

W

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BA

CK

LSO

PR

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LO

REG

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LOW

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DJO, LLC I A DJO Global CompanyT 800.336.6569 D 760.727.1280 F 800.936.6569

1430 Decision Street I Vista, CA 92081-8553 I U.S.A.DJOglobal.com

00-3512 Rev A©2015 DJO, LLC

LSO PREMIUM PLUS PDAC ASSIGNED CODES: L0631 (CST) / L0648 (OTS)

The DonJoy LSO Premium Plus provides rigid anterior and posterior compression from T9 – S1. Similar to the DonJoy LSO with Chairback, but without the lateral supports; the Premium Plus provides a high degree of spinal support while maximizing patient comfort.

LO LITE PDAC ASSIGNED CODES: L0626 (CST) / L0641 (OTS)

The DonJoy LO Lite is a lighter, more breathable version of the LO Low Profile, without the rigid anterior panel. The LO Lite provides support for mild lower back pain, from L1 – L5.

LSO WITH CHAIRBACKPDAC ASSIGNED CODES: L0637 (CST) / L0650 (OTS)

The DonJoy LSO with Chairback combines the DonJoy LSO Low Profile brace with a rigid chairback frame to provide extended spinal support from T9 – S1 in a modular step-down design.

DONJOY BACK BRACESThe DonJoy back brace product line was

designed with function and patient comfort in

mind. The family of back braces provides

support for a broad range of spinal indications;

from acute low back pain relief to post-

operative support/stabilization. Each of the

seven DonJoy back braces offer progressively

more support for the spine, yet all share

common design features:

FEATURES & BENEFITS

>>> Simple hook-loop closure for ease of application and removal

>>> The patented Mechanical Advantage Pulley System provides a powerful, dynamic approach to abdominal compression

>>> Easy-to-use pull handle(s) enable the patient to quickly adjust the brace to a desired level of comfort

>>> Breathable interior spacer fabric with outer mesh allows heat to escape without compromising brace performance

LO REGULAR & LOW PROFILE PDAC ASSIGNED CODES: L0627 (CST) / L0642 (OTS)

The DonJoy LO Regular and LO Low Profile braces provide rigid anterior and posterior compression from L1 – S1. The 10” LO Regular model is designed for patients with longer torsos. The 8” LO Low Profile model will accommodate most patients.

SI BELT PDAC ASSIGNED CODE: L0621

The DonJoy SI Belt provides stabilization of the sacroiliac (SI) joint through direct compression. The silicone grip strips prevent the brace from migrating and “lock” the hips.

DONJOY BACK BRACE II TLSO

The DonJoy Back Brace II TLSO supports the thoracic and lumbar spine from T2 to the sacrum with overlapping rigid panels and an adjustable sternal pad.