Skipping Cross Links in Posterior Spine Surgery: A Review

Introduction: Given the debatable available literature and absence of reliable evidence around usage of cross-links in posterior spine surgery, this review intends to highpoint the different features and usefulness of these augmentation devices in spine surgery. Methods and Materials/Patients: Online records search including PubMed, Google scholar and Ovid was searched using the keywords: spine, instrumentation, pedicular screw, cross-links, scoliosis, deformity, trauma, torsional stability, configurations, and inter-body fusion. As a final point, about 41 associated studies were selected and appraised.   Results: A number of reports have pronounced biomechanical investigation on cross-links (CL) usage, but no certain agreement has been gotten concerning the effects. Very limited studies have tested the location and direction of the CL. Some studies display that the custom of CL can be removed from clinical working. The origins from these studies do not interpret into clinical benefits. Posterior pedicular fixation without cross-links offer stability in all planes in most clinical conditions. Conclusion:   Eradicating the cross-links decreases the surgery time and generally total hospital prices. Furthermore, device failure, prominence of device, infection, pseud -arthrosis and late pain are the other problems related to cross-links in the literature that can be eradicated by avoiding their combination in spinal constructs. Nonetheless, if tendency is consuming cross- links special in degenerative diseases and deformities, studies in animal models, showed the diagonal cross-link configuration providing the most stable construct once matched with rod only systems or with transverse cross-link constructs resultant in rectangular configurations.

کلیدواژه ها:

Cross-links ، posterior spine ، pedicular screw