This is a color video depicting a man with paraplegia resulting from a remote car accident. He developed intractable pressure ulcers, leading to life-threatening pelvic osteomyelitis. The patient's pre-operative appearance, images from his radiological workup, and key points of the intra-operative management are shown. Suppression of infection and nutritional augmentation were emphasized in this patient's care. The first surgical procedure accomplished fecal and urinary diversion and was done at the St. Louis VAMC. The second stage involved spinal transaction and dural closure, aortic and caval division, preservation of testicles on their vascular pedicles, and an extraperitoneal dissection for the amputation. It was done at Saint Louis University Hospital. Post-operative views document an excellent outcome. Many posed views are shown, illustrating technical points of interest to practicing surgeons. Scenes at the end show the patient in his prosthesis, seated in a wheelchair, and driving a car, thus documenting his rehabilitation. He remains well and lives at home three years after surgery. The narrator is a native English speaker and the video was professionally done at the St. Louis VAMC.