Although considerable research has been conducted to reproduce common injuries such as wedge and burst fractures in a laboratory environment, there is a paucity of quantitative data relating the alignment of the cervical spine to the mechanism of injury and associated biomechanical variables. Consequently, this study was conducted to correlate spinal alignment with injury outcomes. Intact human cadaver head-neck complexes were subjected to dynamic loading using an electrohydraulic testing device. The cranium was unconstrained. The inferior end was fixed at the thoracic end. Spinal alignment was defined in terms of initial eccentricity. It was defined as the relationship of the occipital condyles with respect to the first thoracic vertebra. The specimens were placed on an electrohydraulic testing device. They were impacted once on the superior end at velocities ranging from 2.5 to 8.0 m/s. Mechanisms of injury were identified using radiography and computed tomography images. Based on clinical assessment, injuries were classified as stable or unstable depending on the severity of trauma. In addition, injuries were graded according to the Abbreviated Injury Scale (AIS) rating. Trauma classifications were also based on fracture or non-fracture groups. Analysis of variance procedures were used to determine the influence of spinal geometry on injury outcomes. Of the 30 specimens, 17 were in the AIS < 3 group and 13 were in the AIS 3 group. Nineteen specimens had unstable injuries and the remaining structures were stable. Injury mechanisms were: three in compression-extension, five incompression-flexion, nine in hyperflexion, and 12 in vertical compression. Among the injured specimens, 19 had bony fractures with or without ligament injuries. Eccentricity significantly influenced the mechanism of injury (p<0.0001). Eccentricity also demonstrated significant differences between the two AIS groups (p<0.005). When the pathology was classified into fracture fracture groups, eccentricity influenced the outcome of trauma (p<0.0001). In contrast, such statistically significant differences were not apparent when the classification of injury was based on stability considerations. Spinal alignment is a strong determinant on the injury biomechanics of the cervical spine due to dynamic compressive loading.