Cornaz F, Widmer J, Snedeker JG, et al. - The present study was conducted to serve an overview of the available evidence on the effectiveness of cross-links (CL), potentially allowing with formulate recommendations on their use. Researchers conducted a systematic literature review on PubMed and 37 original articles were included and grouped into mechanical, biomechanical, finite element, and clinical studies. The change in range of motion (ROM) was analyzed in mechanical and biomechanical studies, ROM, stiffness, and stress distribution were assessed in finite element studies and clinical outcome parameters were analyzed in clinical studies. It was shown that lateral bending and flexion–extension are less affected, while CL provides some additional axial rotation stability in most situations. According to the results, CL-augmentation can only be recommended for C1/2 instrumentations, while for other cases, future clinical trails are required to allow for evidence-based recommendations.