en Spine Review <div style="text-align: justify;"><strong>Background and Aim</strong>: Given the conflicting and unreliable evidence for using cross-links in posterior spine surgery, this review was conducted to highlight the different features and usefulness of these augmentation devices in spine surgeries.<br> <strong>Methods and Materials/Patients</strong>: After searching databases using specific keywords, the relevant articles were ultimately selected and evaluated.<br> <strong>Result</strong>s: Biomechanically investigating the use of cross-links has not resulted in unanimous explanations for their effect. The site and direction of cross-links have been rarely investigated in the literature. Some studies recommended eliminating their application from clinical practice; nevertheless, these studies do not necessarily yield clinical benefits. Posterior spinal fixation with pedicle screws and without cross-links offers stability in all the planes in most clinical conditions.<br> <strong>Conclusion:</strong> Excluding the cross-links in posterior spine surgery may shorten the operation time and reduce hospital costs. Researchers have reported other problems for cross-links such as late pain, device failure, infections, device prominence, and pseudarthrosis which may be obliterated&nbsp;through the avoidance of their combination in a spinal construct; nevertheless, the results of animal models of the application of special cross-links in a degenerative disorder or deformity suggest that diagonal cross-links provide the highest stability of the construct if they are matched with a rodonly system or with transverse cross-link constructs resulting in a rectangular configuration.</div> Cross-links, posterior spine, pedicular screw 49 56 http://irjns.org/browse.php?a_code=A-10-34-7&slc_lang=en&sid=1 Misagh Shafizad paper87@yahoo.com 10031947532846005551 10031947532846005551 Yes Associate Professor of Neurosurgery, Spine Fellowship, Department of Neurosurgery, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Kaveh Haddadi kh568hd@yahoo.com 10031947532846005552 10031947532846005552 No Assistant Professor of Neurosurgery, Orthopedic Research Center, Imam Khomeini Hospital, Sari, Iran.