Mulpuri et al. sternal-split approach to cervicothoracic junction. A, Incision for right-sided approach. B, Sternum is opened, thymus gland is resected, and brachiocephalic trunk is mobilized to allow contiguous access to anterior cervical spine and upper thoracic spine. C, Retraction of trachea, esophagus, and innominate artery provides access to lower cervical spine and upper thoracic spine. D, Medial displacement of brachiocephalic trunk allows more distal access to thoracic spine. SEETECHNIQUE 43.21.