A man in China has reclaimed his life after undergoing an intense spinal surgery that allowed him to stand, lie down, and even look straight ahead—things he hadn't been able to do for years.

The "Folding Man"

46-year-old Li Hua was known as the "Folding Man" due to his upper body being permanently folded forward, bending onto his lower limbs. Diagnosed with ankylosing spondylitis at the age of 18, he and his family couldn’t afford treatment for the condition. Over time, his painful joints made it increasingly difficult to stay upright, and he eventually reached a point where sitting, lying down, or even eating and drinking became a struggle. His home province in Central China, Hunan, refused to provide medical care, deeming it too dangerous and life-threatening.

However, Professor Tao Huiren, the head of spinal surgery at Shenzhen University General Hospital, took on the challenge. Having treated similar conditions before, Huiren was faced with one of the most severe cases of ankylosing spondylitis.

"Our only option was to break his bones in sections—his femur, cervical vertebrae, thoracic vertebrae, and lumbar vertebrae—and then straighten his spine," Professor Huiren said. "The risks were 20 to 30 times greater than a typical spinal surgery, and there was a high chance he could become a paraplegic."

The surgery was successful, and for the first time in 28 years, Li Hua could stand, sit, and lie down comfortably.

What is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis that primarily affects the spine. It typically starts in adolescence or early adulthood and is characterized by back pain and stiffness. As the disease progresses, the vertebrae fuse, limiting movement in the back, a process known as ankylosis.

AS begins in the sacroiliac joints, located between the sacrum (base of the spine) and the iliac bones of the pelvis. The inflammation then spreads to the rest of the spine, leading to spondylitis. The condition can also affect other joints like the hips, shoulders, and sometimes the knees, and may impact the joints between the spine and ribs, restricting chest movement and making deep breathing difficult. In some cases, AS can cause eye inflammation, known as iritis or uveitis.

How Does AS Develop?

The exact cause of ankylosing spondylitis remains unclear, but it is considered an uncommon condition, affecting approximately 0.2 to 0.5% of the U.S. population. AS is thought to be hereditary, with genetic markers like the HLA-B27 antigen increasing the likelihood of developing the disease.

HLA-B27:
HLA-B27 are antigens—proteins found on the surface of white blood cells that help fight infections. If you have this antigen in your blood, it could indicate an autoimmune disease, where your immune system mistakenly attacks your body’s own cells. Ankylosing spondylitis is one of the most common autoimmune diseases linked to HLA-B27, and a simple blood test can detect it.

Treatment for Ankylosing Spondylitis

The primary goal of treatment for AS is to relieve pain and stiffness and prevent spinal deformities. The most successful treatment occurs when the condition is caught early, before irreversible spinal damage occurs.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are typically the first line of treatment for AS. They help reduce inflammation, pain, and stiffness but may cause gastrointestinal issues. If NSAIDs are ineffective, doctors may prescribe biologic medications such as TNF blockers or IL-17 inhibitors, which target inflammation and help alleviate pain and stiffness.

Physical therapy is also crucial for managing AS, as it can improve strength and flexibility and provide pain relief. Surgery is generally considered a last resort for patients with severe joint damage, and most people with AS do not need surgery.

Li Hua’s Successful Surgery

Li Hua’s surgery was groundbreaking, as it was the first time such severe spinal deformities had been corrected in China. He currently uses a walker to assist with movement, but doctors are confident that with a few months of physical therapy, he will be able to move normally again.

"Of course, he won’t be able to do anything too extreme, like boxing or playing tennis, but all normal movements should be no problem," said Professor Huiren.

The surgery gave Li Hua his life back, and he is deeply grateful, especially to his mother, who had been his primary caregiver for most of his life. "Without Dr. Tao, there would have been no cure for me. He’s my savior, and my gratitude to him is second only to my mother," Li Hua expressed.

Li Hua's story is a testament to the resilience of the human spirit and the power of modern medicine to restore quality of life, even in the face of severe medical challenges.