1. Clinical data The patients in this group were 16 cases and 16 sides, 7 cases of men and 9 cases of women, aged 34-78 years (45.8±2.6 years). There were 5 cases of hand muscle weakness, 13 cases of ulnar sensory numbness and hypesthesia in the hand and forearm, 4 cases of sensory numbness in the neck and shoulder, and 7 cases of blood flow changes in the affected limb with body position. One of them had a combined ipsilateral lower pole thyroid cyst. All patients underwent preoperative MRI, CT, X-ray or ultrasound to exclude cervical spondylosis, local tumor and other diseases related to localization signs. All patients had oblique interval pressure pain and radiating pain. 9 cases had positive Adson’s test. Inclusion criteria: the criteria proposed by Chen Desong were met [3]: 1, history of cervical arm pain, numbness, soreness, cold, abnormal sensation, and unfavorable activity; 2, sensory impairment was obvious in the medial forearm and ring little finger, and the interval pressure pain of the oblique muscle was obvious and radiated to the upper limb, which could be accompanied by reduced muscle strength, muscle atrophy, and reduced or unevoked tendon reflexes of the affected limb; 3, five symptom provocation tests (shoulder abduction test Wright’s sign, the rhomboid squeeze test Adson’s sign, the upper arm ischemia test Roose’s sign, the rib lock squeeze test Eden’s sign and the supraclavicular snapping test Moselege’s sign); 4. No congenital malformations such as cervical ribs, abnormal thoracic ribs, or long transverse processes of the 7th cervical vertebrae were found in the frontal and lateral cervical X-rays. 5. The results are not good. 2.Supine position, brachial plexus + cervical plexus anesthesia, and transverse incision in the supraclavicular fossa. The anterior and middle oblique muscles were cut off near the end of the transverse cervical process, and the small oblique muscles were also cut off if the small oblique muscles were found to be compressing the lower trunk of the brachial plexus. The subclavian artery was explored partially according to the length of 2-3 cm. 3. Results The wounds of 16 patients on all sides healed in one stage after surgery, and the stitching time was 5-7 days. Nine of the patients were discharged with complete relief of symptoms, 4 patients had bright relief of symptoms, and 2 patients had insignificant relief of symptoms, which was relieved by dehydration, physiotherapy, nerve nutrition and pain relief. One case was ineffective. The good rate was 81.3%. All patients were followed up from 4 months to 1 year. 13 patients had relief of symptoms within 3 months, with disappearance of numbness, return of muscle strength, disappearance of pain, and no recurrence. 2 patients experienced pain in the upper arm at night that interrupted sleep and required pain medication. One patient had no postoperative symptom relief and had limited abduction, forward flexion and back extension of the affected upper limb. 4.1 Anterior oblique muscle syndrome is a type of thoracic outlet syndrome, due to the compression of the brachial plexus nerve and subclavian artery at the thoracic outlet by the anterior oblique muscle with spasm, hypertrophy and degeneration, and its compression site is mostly across the first rib, often the lower brachial plexus trunk and subclavian artery compression, clinical manifestations are hypotonia, numbness of the forearm and ulnar side of the hand, and cold white, pain and Radicular pain. This disease is not uncommon in clinical practice, but because of its similar clinical manifestations with neurogenic cervical spondylosis, rotator anterior round muscle syndrome, carpal tunnel syndrome, Raynaud’s syndrome and other diseases, and because there are not many reports on this disease in the literature, it is easily overlooked and misdiagnosed by physicians.4.2 A clear diagnosis must be made before surgery, and MRI, CT, X-ray or ultrasound examinations are feasible to exclude ipsilateral cervical spondylosis, local tumors, metastatic cancer, cervical ribs. The clinical manifestations of anterior oblique muscle syndrome are crossed with cervical spondylosis, carpal tunnel syndrome, and Raynaud’s syndrome. Careful differentiation must be made, as both cervical spondylosis and anterior oblique angle muscle syndrome will have a positive brachial plexus pull test, and pain in cervical spondylosis is mostly associated with head position, while the latter is mostly associated with changes in upper extremity position. The oblique angle muscle gap fullness pressure pain and upper limb radiating pain are extremely closely related to it. Some patients also have transvertebral disc herniation magnetic resonance changes, at which time the localization diagnosis of nerve compression needs to be analyzed, and if it cannot be clarified or crossed, this procedure should not be performed rashly. The invalid patient in this group was a patient with confirmed cervical spondylosis and also had interval pressure radiating pain in the oblique muscles, and the pain was closely related to the position change of the upper limb. 4.3 Modified oblique muscle severance was used, which means that not only the anterior middle oblique muscle but also the lesser oblique muscle was severed during the operation. The rate of appearance of the small oblique muscle in the national population is, 88.3, %. The small oblique muscle originates from the anterior and posterior nodes of the C7, transverse process and, C6, transverse process, covering the anterior superior part of the first posterior rib, and its anterior edge is tendinous tissue, which is easily mistaken for an abnormal fasciculus during surgery [2]. the C8, T1, nerve root and its synthesized inferior trunk cross the anterior edge of the small oblique muscle from below, and the anterior edge of the beginning of the small oblique muscle can form a snag on the inferior trunk of the brachial plexus or The anterior edge of the beginning of the lesser oblique muscle can form a compression on the lower trunk of the brachial plexus or the T1 nerve root, and there is also elevation of the subclavian artery and sympathetic nerve compression. In this group, the small oblique muscle was found in 13 cases, and all of them were cut. The intersection of the anterior and middle oblique muscles starting at the anterior and posterior nodes of the cervical 4 and 5 transverse processes can cause compression of the cervical 5 and 6 nerve roots and the dorsal scapular nerve [3]. It is necessary to completely release the anterior and middle oblique muscles and the lesser oblique muscles intraoperatively. In cases of cold and white extremities, the epicranial stripping of the subclavian artery and the release of the epicranial membrane of the inferior trunk nerve are performed, and the length of the dynamic epicranial stripping is 2 to 3 cm.