TRAP DOOR EXPOSURE OF THE CERVICOTHORACIC JUNCTION

This report describes a ''trap door'' exposure of the cervicothoracic junction. The method combines a standard anterior approach to the spin e along the medial border of the sternocleidomastoid muscle with both a partial median sternotomy and an anterolateral thoracotomy. Transect ion of the clavicle is not required and the sternoclavicular joint is preserved. With this method, all important ventral paravertebral vesse ls, nerves, and associated soft tissue are fully identified and readil y mobilized as needed. The method provides full bilateral anterior exp osure from the C-4 through at least the T-3 vertebral levels, as well as unilateral anterolateral access to the upper thoracic spine.