A sample of 290 casualties who received a moderate to fatal spinal injury (AIS ≥ 2) was analysed to identify some of the factors involved. Impact type, seating position and seat belt use were not found to influence the location of spinal injury. However seat belt use was found to result in less severe injuries. Females had higher involvement rates in the incidence of cervical and thoracic spinal injuries. A high degree of cord trauma was associated with cervical spine injury, which was not seen in the thoracic and lumbar regions. Some 21% to 37% of the occupants experienced a spinal injury without a moderate to fatal injury (AIS ≥ 2) to any other body region. The head/face was the most frequent site for an impact to result in cervical (51%), thoracic (49%) and lumbar (39%) spine injury. Prevention of a head/face impact may well help to reduce the incidence of spinal injuries.