In a 65-year-old patient, an infection of the lumbar spine (T12-L1) caused by Staphylococcus aureus caused cauda equina syndrome and subsequently a massive infectious decubitus in the sacrococcygeal area with dimensions of 5 × 5 cm. Symptoms of decubitus were masked by back pain, analgesics, neurological deficits, and systemic infection. Prolonged immobilization and neurogenic incontinence of the bladder and bowels contributed to the formation of bedsores. Treatment included single-stage surgical debridement of the spine with internal fixation and debridement of the sacrococcygeal ulcer using vacuum seal drainage (VSD) in both areas. Infection was controlled by repeated VSD changes, antimicrobial therapy, and nutritional support. The spinal infection was cured and the pressure sores healed. The case highlights the importance of early prevention and identification of sacrococcygeal ulcers in patients with lumbar infection and neurological deficit.