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Systematic Review

Does the Current State of Evidence Justify the Broad Use of Cross-Links in Dorsal Instrumentation? A Systematic Review

1
Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
2
Center for Spinal Surgery, Schön Klinik Düsseldorf, Am Heerdter Krankenhaus 2, 40549 Düsseldorf, Germany
3
Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
*
Authors to whom correspondence should be addressed.
Academic Editor: George Alexiou
Received: 17 January 2021 / Revised: 1 March 2021 / Accepted: 11 March 2021 / Published: 29 March 2021
Cross-links increase the stability of screw-rod systems in biomechanical testing. The aim of this systemic review was to find evidence pertaining to the additional benefit of the implantation of cross-links in clinical practice in regard to different spinal diseases. Therefore, a systematic literature analysis of two online databases was performed according to the PRISMA statement. Inclusion criteria were prospective and retrospective studies investigating the use of cross-links in dorsal instrumentation. Biomechanical studies and case series were excluded. A total of seven retrospective studies remained for final full-text evaluation. In total, two studies each address the use of cross-links in adolescent idiopathic scoliosis, neuromuscular scoliosis or atlantoaxial fusion, one study in congenital scoliosis. In atlantoaxial fusion the additional use of cross-links may provide earlier bony fusion. In surgical treatment for pediatric scoliosis the additional use of cross-links does not provide additional benefit. Radiological outcome and complication rate did not differ in between groups. No study addressed the use of cross-links in short- or long-segment fusion due to degenerative or traumatic disorders of the spine. There is a deficiency in published literature towards the impact of cross-links in spinal surgery. The current clinical evidence data do not confirm the biomechanical advantages of cross-links in clinical practice. Further studies are needed to warrant the use of cross-links in the future. View Full-Text
Keywords: spine; spinal surgery; dorsal instrumentation; spinal fusion; cross-link; stability; systematic review; evidence-based-medicine spine; spinal surgery; dorsal instrumentation; spinal fusion; cross-link; stability; systematic review; evidence-based-medicine
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MDPI and ACS Style

Heck, V.J.; Oikonomidis, S.; Prasse, T.; Meyer, C.; Scheyerer, M.J.; Wetsch, W.A.; Eysel, P.; Bredow, J. Does the Current State of Evidence Justify the Broad Use of Cross-Links in Dorsal Instrumentation? A Systematic Review. BioMed 2021, 1, 1-10. https://0-doi-org.brum.beds.ac.uk/10.3390/biomed1010001

AMA Style

Heck VJ, Oikonomidis S, Prasse T, Meyer C, Scheyerer MJ, Wetsch WA, Eysel P, Bredow J. Does the Current State of Evidence Justify the Broad Use of Cross-Links in Dorsal Instrumentation? A Systematic Review. BioMed. 2021; 1(1):1-10. https://0-doi-org.brum.beds.ac.uk/10.3390/biomed1010001

Chicago/Turabian Style

Heck, Vincent J., Stavros Oikonomidis, Tobias Prasse, Carolin Meyer, Max J. Scheyerer, Wolfgang A. Wetsch, Peer Eysel, and Jan Bredow. 2021. "Does the Current State of Evidence Justify the Broad Use of Cross-Links in Dorsal Instrumentation? A Systematic Review" BioMed 1, no. 1: 1-10. https://0-doi-org.brum.beds.ac.uk/10.3390/biomed1010001

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