Criterion of Cho et al. for use of the standard Smith-Robinson approach for upper thoracic anterior fusion. A, On a preoperative lateral radiograph, a line drawn from the intended skin incision to the top of the manubrium (at the suprasternal notch) to the level of the disc space (T1-2) indicated that this trajectory would allow adequate exposure of the cervicothoracic junction. B, Fusion done through standard Smith-Robinson approach.