Direct anterior approach to the cervicothoracic spine (C7-T4) poses a technical challenge in neurosurgery, due to the presence of important neurovascular structures anterior to the cervicothoracic junction (CTJ). Median Sternotomy approach is a surgical option that allows for direct anterior exposure of the lower cervical and upper thoracic vertebrae. We report the first case from Ghana, West Africa of a young man who developed post-tuberculosis osteomyelitis of upper thoracic (T1-2) vertebrae with cord compression after spinal tuberculosis in childhood. He underwent a full median Sternotomy for Anterior Decompression and Fusion of C7-T2 with autologous iliac crest bone graft. We detail our operative procedure and review the relevant literature.