Figure 4: Sacrectomy at S2 level. A 67-years-old male urinary and bowel disfunction and prominent tumor at the back of sacrum. Magnetic resonance images show huge sacral chordoma below S2 level (dimensions 20 cm × 12 cm) (a and b). In 2006, we performed a sacrectomy at S2 level with combined anterior-posterior approach. (c and d) Since the rectum was invaded by the tumor, a prophylactic colostomy opened. After posterior osteotomies excessive bleeding caused immediate closing by leaving an abdominal gauze ventrally. The abdominal gauze and drains were removed 2 days later. Postoperative deep wound infection needed a revision surgery with irrigation drains. He was lost to follow-up after 1 year