• Christian Fisahn, Cameron Schmidt, Steven Rostad, Rong Li, Tarush Rustagi, Fernando Alonso, Mohammadali M Shoja, Joe Iwanaga, Jens R Chapman, Rod J Oskouian, and R Shane Tubbs.
• Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA; Seattle Science Foundation, Seattle, Washington, USA; Department of Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Germany. Electronic address: christian.fisahn@swedish.org.
• World Neurosurg. 2017 May 1; 101: 42-46.

IntroductionThe apical ligament has long been reported to contain notochord remnants and thus might serve as a site of origin of chordoma formation at the skull base. However, to our knowledge, the histologic study of the apical ligament using histologic staining specific for notochordal tissue has not been previously performed. Therefore the current study was undertaken.MethodsFifteen apical ligament samples underwent histologic examination with specific markers for notochordal differentiation.ResultsAcross all samples, there was no indication of any notochordal remnants.ConclusionsOn the basis of our cadaveric study, the apical ligament does not contain notochord tissue and in adults should not be considered a remnant of this structure. Moreover, it is unlikely that the apical ligament gives rise to chordomas at the craniocervical junction under normal circumstances.Copyright © 2017 Elsevier Inc. All rights reserved.

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