Anterior approach to cervicothoracic junction without sternotomy. A, Incision for exposure at cervicothoracic junction. B, Sagittal section of the chest reflecting the thoracic spine exposure possible with upper manubrium resection and retraction.(Redrawn from Pointillart V, Aurouer N, Gangnet N, Vital JM: Anterior approach to the cervicothoracic junction without sternotomy: a report of 37 cases, Spine 32:2875, 2009.) SEE TECHNIQUE 37.11.