• Joe Iwanaga, Juan P Sardi, Tyler Laws, Jens R Chapman, Rod J Oskouian, and R Shane Tubbs.
• Seattle Science Foundation and Swedish Neuroscience Institute, Seattle, Washington, USA; Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan. Electronic address: joei@seattlesciencefoundation.org.
• World Neurosurg. 2017 Nov 1; 107: 1012-1015.

ObjectiveFour layers of ligamentous stabilizers comprise the craniocervical junction, and the second layer is composed of apical and paired alar ligaments. The purpose of this study is to establish the tensile strength of the alar ligaments for better understanding the implications that can arise from trauma and other pathologies in the craniocervical region.MethodsNineteen sides from 10 fresh frozen adult cadaveric Caucasian heads were used in this study. The specimens were derived from 6 males and 4 females, and the age of the cadavers at death ranged from 67-90 years old. To measure the tensile strength, a tensile testing machine (M2-200, Mark-10 Corporation, Copiague, New York, USA) was used in this study.ResultsThe force (N) necessary until failure for all alar ligaments ranged from 87-346 N with a mean of 186.9 ± 69.7 N. There was a significant difference when comparing tensile strength between males and females.ConclusionsFurther studies will be necessary to determine their importance as secondary stabilizers and measure their ability to support similar forces when subject to rotation and lateral bending forces, as well as with flexion-extension.Copyright © 2017 Elsevier Inc. All rights reserved.

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