When the head, neck and spine are in the exact, natural alignment. Vital with spinal casualties as any major damage to the spine can result in serious problems, the worst case scenario being paralysis, or even death.
This is why you'll see people holding the head straight, to minimise any movement of the c spine, aka, the cervical spine (the bit of spine in your neck). Damage to this area definitely means trouble, and a properly-fitted collar will help prevent this too.
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