Spinal cord ischemia is rarely reported after segmental vessel ligation. Spinal angiography allows determining the topography of the Adamkiewicz artery safely. If the planned surgical approach is located at the same level, a contralateral approach or selective surgical techniques without vessel ligation could avoid possible damage to the Adamkiewicz artery if the pathology does not dictate the side and the extent of the surgical approach.

The differences observed are small and have probably little clinical relevance. The distal cortical axis may be the best compromise. The navigation system allows measuring accurately the orientation of the distal femoral resection in the sagittal plane.

No abstract