Complex Spinal Revision Surgery in China: A Patient Travels from Italy to Shenzhen for Treatment

For patients who have undergone spinal surgery many years earlier, new problems can sometimes develop around old implants or adjacent areas of the spine.

These cases can be particularly difficult when previous screws are located close to nerves, the original implant system is no longer commonly used, or a new spinal deformity has developed above the previous surgical area.

One patient featured in a case published by The University of Hong Kong–Shenzhen Hospital (HKU-SZH) faced exactly this situation.

After being told that further surgery carried a very high risk, she eventually travelled to Shenzhen for another specialist evaluation.

This article is based on a patient case originally reported by HKU-Shenzhen Hospital.

A Spinal Injury Treated 26 Years Earlier

Approximately 26 years before her treatment in Shenzhen, the patient suffered a lumbar spinal fracture after falling down a staircase in Italy.

Doctors stabilized her spine using four screws.

For around two decades after the original surgery, she was reportedly able to return to relatively normal life.

But in 2020, her condition began to change.

Her back gradually started bending forward, and standing upright became increasingly difficult.

Walking for more than a few minutes caused significant discomfort and weakness in her lower back and legs, forcing her to stop and rest.

Her mobility and quality of life progressively deteriorated.

Doctors Considered Revision Surgery Too Risky

The patient sought medical advice from several doctors and hospitals in Italy.

According to the hospital's case report, specialists were particularly concerned about the position of one of the old spinal screws, which was located extremely close to neural structures.

She was advised that attempting to remove or revise the implant could carry a serious neurological risk.

After consulting several physicians, conservative treatment was repeatedly recommended.

For several years, she believed that major corrective treatment might no longer be possible.

Searching for Another Spine Surgery Opinion

A new possibility emerged after the patient learned about another complex spinal deformity case that had previously been treated in Shenzhen.

Her family eventually identified Professor Tao Huieren, Director of the Orthopaedic Medical Center at The University of Hong Kong–Shenzhen Hospital.

She travelled to Shenzhen with her previous medical records and imaging for further assessment.

After reviewing the case, the spinal surgery team determined that the condition was extremely difficult but potentially operable.

Why Was the Case So Complex?

The problem involved much more than simply removing old screws.

According to the hospital, of the four screws implanted approximately 26 years earlier:

• two had entered the spinal canal

• one had migrated outside the vertebral body

• the previous surgical area had become anatomically complex

In addition, the patient had developed a new deformity above the previous fusion.

This was described as proximal junctional kyphosis (PJK).

What Is Proximal Junctional Kyphosis?

PJK refers to an abnormal forward curvature that develops near the upper end of a previous spinal fusion.

In simplified terms, a previously stabilized section of spine changes the way forces are distributed through neighbouring segments.

Over time, the area immediately above the fusion may experience increased mechanical stress and structural changes.

PJK can range from relatively mild radiographic changes to significant deformity associated with pain, imbalance or neurological problems.

In this patient's case, the spinal team needed to address both:

the old and potentially dangerous spinal implants

and

the newer spinal deformity above the previous surgical area.

Planning a Complex Spinal Revision

The team developed a comprehensive revision strategy.

According to the case report, the planned treatment involved several components:

• removal and revision of old spinal instrumentation

• decompression to create more space around affected neural structures

• osteotomy to correct the spinal deformity

• reconstruction of spinal alignment

• placement of new internal fixation

The goal was to improve spinal alignment and allow the patient to stand and walk more effectively.

However, before surgery could proceed, the team encountered another unusual problem.

Were 26-Year-Old Spinal Implants Safe for MRI?

The medical team wanted a whole-spine MRI to further evaluate the patient's condition.

But no one initially knew exactly what material had been used for the spinal implants placed in Italy in 1999.

Determining implant composition was important before proceeding with MRI.

The patient's only historical documentation was an old handwritten Italian surgical record referring to a “Socon” system.

The implant system had been discontinued many years earlier.

Rather than assuming what material had been used, the medical team attempted to trace the original device.

According to HKU-SZH, the team reviewed historical information and eventually contacted the European manufacturer associated with the implant system.

The manufacturer confirmed that the implant was made of titanium alloy and could undergo MRI under the relevant conditions.

This allowed the medical team to complete the imaging required for surgical planning.

Spinal Revision Surgery in Shenzhen

The operation was performed on 5 December 2025.

According to the hospital, Professor Tao and his team completed the planned:

• osteotomy

• deformity correction

• spinal decompression

• revision of internal fixation

The operation was described as technically challenging because of the old instrumentation, altered anatomy and proximity to neurological structures.

Three days after surgery, the patient was able to stand with medical assistance.

She reported improvement in the heavy downward sensation in her lower back and felt that her legs were stronger.

She was subsequently discharged on 15 December 2025 following postoperative recovery.

What Can International Patients Learn From This Case?

This case does not mean that every patient who has previously been told that spinal revision surgery is too risky will be eligible for surgery in China.

Complex spinal revision procedures carry significant risks and require individualized assessment.

However, the case illustrates why obtaining another specialist opinion may be worthwhile when a patient has:

• previous spinal instrumentation

• broken, displaced or malpositioned implants

• recurrent spinal deformity

• proximal junctional kyphosis

• spinal canal narrowing

• progressive difficulty standing or walking

• neurological symptoms

• a proposed high-risk spinal revision

• been told that further surgery may not be possible

A specialist at a high-volume spine centre may assess the problem differently depending on their experience with complex deformity and revision surgery.

What Medical Records Are Useful for a Spine Surgery Second Opinion?

Patients seeking another opinion about complex spine surgery should ideally prepare as much previous information as possible.

Useful records may include:

• recent X-rays

• CT scans

• MRI scans and reports

• previous surgical records

• details of implanted devices

• operative reports

• discharge summaries

• current symptoms

• neurological examinations

• medication history

• previous treatment recommendations

For very old spinal implants, any information about the manufacturer, model or implant material may also be important.

Considering Spine Treatment in China?

For international patients, travelling to China before knowing whether a specialist believes further treatment is worthwhile can involve significant cost and effort.

A medical-record-based specialist consultation may therefore be a practical first step.

China Specialist Second Opinion

China MedCare can help international patients have their existing medical records reviewed by an appropriate specialist in China.

We can assist with:

• organizing existing medical records

• preparing a structured Chinese medical summary

• identifying an appropriate spine specialist

• translating medical questions

• coordinating the specialist consultation

• translating the doctor's responses into English

• facilitating follow-up questions during the consultation period

• exploring hospital appointments in China if further evaluation or treatment is recommended

Second Opinion: US$49–99

You can review the specialist's background, hospital and total consultation price before deciding whether to proceed.

No travel is required to get started.

Medical Disclaimer

This article is for general informational purposes only and does not constitute medical advice, diagnosis or a recommendation for spinal surgery.

The patient case described above was originally published by The University of Hong Kong–Shenzhen Hospital. Clinical details and outcomes are based on the hospital's account. China MedCare was not involved in the patient's treatment.

Complex spinal revision surgery can involve significant neurological, surgical and anaesthetic risks. Whether surgery is appropriate must be determined by a qualified spine specialist after reviewing the individual patient's condition.