A 39-year-old woman presented to a chiropractic clinic with hand and arm numbness that began after she was injured in a motor vehicle collision 18 months earlier. The primary symptom was TVL that began 3 days after the motor vehicle collision. At that time, she had been diagnosed with bow hunter syndrome using dynamic angiography findings. She had previously declined surgery recommended by her attending neurosurgeon at a local hospital.

Intervention and Outcome

The patient was treated using atlas orthogonal chiropractic technique for 8 visits over a 6-week period. Examination before and the after the initial treatment included cervical radiographic analysis and vascular ultrasound measurement of the right and the left vertebral artery (VA). After the initial spinal manipulation, there was an improvement in blood flow volume of 8.2% in the left VA and 22.2% in the right VA. There was improvement of the symptom of TVL and a measured reduction of rotational misalignment of the first and second cervical vertebra on the radiographic views. After 6 weeks, the patient’s perception of TVL was absent.