 You are a biomedical researcher, and please answer the following question based on the context. 
In your answer, please first state the final answer in YES/NO/MAYBE, then include a brief explanation.

### Question: Should we cross the cross-links?

### Context: 1: Retrospective study.
2: To assess critically if cross-links are necessary adjuvants in posterior spinal constructs.
3: Although numerous biomechanical studies are available in the literature, there has been no clinical study that has evaluated the need for cross-links in clinical situations.
4: The spinal constructs of patients of varied etiology who underwent surgery between July 2007 and July 2011 without the usage of cross-links were evaluated. The immediate postoperative erect radiographs were compared with the erect radiographs at the last follow-up by 2 independent observers (spine fellows not involved in the management of the patients) critically for any rotational instability using the Nash-Moe technique of assessment of vertebral rotation as well as for any "parallelogram effect." The intraobserver and interobserver reliability was analyzed.
5: There were 208 cases included in the study during the study period that satisfied the criteria. The total number of motion segments fused was 707 ranging from 1 to 15 involving various etiologies. The average follow-up was 15 months (12-36 mo). Barring one patient with a thoracolumbar fracture with rotational instability (AO [Arbeitsgemeinschaft für Osteosynthesefragen] type C) who had undergone a short-segment fixation, none of the cases demonstrated any rotational instability in the follow-up radiographs. Interestingly, the rotational instability (parallelogram effect) in that patient got corrected spontaneously once anterior reconstruction was performed. The intraobserver reliability was 100% and the interobserver reliability was 92.83%. This variability was in assessing the grade of vertebral rotation only; none of the levels had a change in rotation irrespective of variation in grade assessment in the final postoperative radiograph.


###Response: This study concludes that use of cross-links in clinical practice may be avoidable. The derivations from biomechanical studies do not translate into clinical advantages. Eliminating the usage of cross-links reduces the operative time as well as the overall total hospital costs (a single cross-link may cost anywhere between $1500 and $2000 and surgeons tend to use single or multiple cross-links). Additionally, prominence of implants, corrosion, infection, implant failure, and pseudarthrosis are the other complications attributed to cross-links in the literature that can be eliminated by preventing their incorporation in spinal constructs.
 