Doctors reveal surgical miracle which saved China’s ‘folded man’

Alice Yan
·6-min read

China’s “folded man” Li Hua has a rare condition that left him with a severely deformed spine. In the final of a three-part series, we look at the challenges faced by the team of doctors in Shenzhen who helped him to stand straight again.

Straightening Li Hua’s folded body was the orthopaedic equivalent of climbing the Himalayas, according to the doctor who managed the remarkable achievement last year.

Li, a 47-year-old from rural Hunan province, was “folded” in three places – with his chin on his chest, sternum on pubis, and his face less than 3cm from his thighs. The deformation was caused by ankylosing spondylitis, an immune system disorder affecting the spine and hip joints.

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Li first experienced symptoms when he was 18 but his condition was initially misdiagnosed as arthritis. When it was finally identified as AS, doctors told him they could do nothing because his body was by then too seriously bent over.

Li Hua was completely folded over before the surgeries. Photo: Handout
Li Hua was completely folded over before the surgeries. Photo: Handout

Finally, in June of last year, Tao Huiren, director of the department of spinal surgery at the Shenzhen University General Hospital, told him he would “have a try”. But, although he was familiar with the condition, Tao had never seen such a serious case.

“When I saw him for the first time, I was shocked. I didn’t imagine that his face would be so close to his thighs,” Tao said.

After Li and his mother arrived at the Shenzhen hospital, doctors spent more than a month treating a festering wound on his belly, caused by the squeeze between his chest and his thighs. Meanwhile, Tao spent two weeks designing a surgery plan, eventually deciding to unfold Li’s body in four steps.

The first surgery took place in August last year and involved forcing Li’s thighs away from his face by breaking the neck of both femurs. That was the easy part. The biggest challenge was how to give him oxygen during the operation because of the limited access to his airway.

“We had to intubate through his nose when he was awake. It’s not a big deal for ordinary people, but for Li Hua, it was extremely difficult as his face was completely covered by his legs,” said Sun Yanyuan, an anaesthesiologist in Tao’s team.

“If I failed to intubate, there was no way to do the first surgery. We would have to give up all the following surgeries,” she said.

To prepare for the ordeal of being intubated while conscious and without anaesthetic, Li spent weeks practising blowing up balloons, an exercise which later helped him cooperate with Sun for the two minutes required for the procedure. When it was successfully completed, all the doctors and nurses in the operating room applauded.

“I didn’t feel comfortable during those two minutes. But I knew this was my only chance and I must cooperate well,” Li recalled.

Two weeks later, Tao performed the second surgery, raising Li’s head by breaking some of his cervical vertebra and inserting artificial components to support his neck. It was the most risky procedure of all, according to Tao, who said failure would have left his patient with paraplegia.

The operation was a success. For the first time in two decades, Li saw his mother’s face.

How a mother’s love saw China’s ‘folded man’ through years of pain

Three weeks later, Tao turned his attention to the C-shaped upper half of Li’s body. For the third surgery, he needed to break the worst affected part of Li’s spine and, using a series of screws, put it back together in a straighter form. After this operation, Li was able to lie flat in his bed.

But, after sleeping on one side for 20 years, getting used to something so simple was not easy. In the days after the procedure, Li said he felt as if something heavy was pressing on his chest and he could not fall asleep.

Months after his treatment began, Li’s fourth and final operation was carried out at the end of October. Tao inserted artificial hip joints so that his patient would finally be able to stand and, eventually, walk again.

Seven days after his last surgery, Li said he needed the support of four doctors to get up off his hospital bed. He was too weak and felt dizzy when he was finally brought to his feet.

“I practised with a walking aid. It took me five minutes to walk for just four metres. I sweated so much that my clothes were totally wet,” Li said.

Li Hua after his fourth operation. Photo: Handout
Li Hua after his fourth operation. Photo: Handout

Tao said he performed these difficult surgeries because he could not turn down the challenge. “I said to myself, ‘I must do it, no matter how I do it,’” he said. Li’s life was also at stake. Without the operations, he would not have lived much longer, Tao said.

“He had too little food every day. His skin was infected because of a festering wound on his belly. His lung function was also not good, as his chest was pressed against his thighs.”

Zhao Jian, a spinal surgeon from Shanghai Changzheng Hospital, said the four surgeries performed by Tao were “a classic way” to correct folded bodies like Li’s. But whether a hospital could embark on such a task depended on its overall capacity as it involved doctors from multiple departments.

“The thorniest part is intubating. Breaking and repairing a patient’s bones are not so hard for us surgeons,” Zhao said.

In March, Li underwent another operation to treat a stomach problem, caused by years of painkilling medication.

Li Hua practises calligraphy at home, with his niece and friend looking on. Photo: Alice Yan
Li Hua practises calligraphy at home, with his niece and friend looking on. Photo: Alice Yan

The total cost of his medical care came to 850,000 yuan (US$127,000), but Li’s family only had to pay 45,000 yuan. Half of the bills were covered by China’s rural medical insurance scheme, while two domestic charity organisations donated a further 200,000 yuan.

Finally, the Shenzhen hospital deducted 100,000 yuan from the bill while its medical staff donated 30,000 yuan to their patient. “I am very thankful for the Shenzhen University General Hospital and doctors there,” said Li, who is undergoing rehabilitation exercises at home in Hunan.

“Doctor Tao treats me like my parents do. After these surgeries, I feel I am reborn.”

Read part one of this series, which tells how Li Hua found happiness and hope, and part two, about the mother’s love that saw him through years of pain.

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