The scan shows vertical fractures of the bodies of C3, 4 and 5

The real clue here is in the history (ejection, damage to the top of the helmet) which suggests that the patient landed on his head. A cervical spine injury is very likely

In retrospect it's easy to convince yourself that there are changes on the lateral C-Spine x-ray, but given the nature of the fractures that's actually quite unlikely

The lesson is that an AP of the neck is always necessary, and that with modern 16 or 32 slice CT scanners a CT may be a better option in a ventilated patient than a secondary trip to the plain x-ray facility. Already most radiologists agree that there is good evidence for C1/2 views whenever a CT head is done in trauma in a patient with altered sensorium. If a C7/T1 view is also necessary as in this case then whole neck CT is a small extra step.

Upper Cervical Spine CT in patients with altered sensorium