Chest compressions, used in cardiopulmonary resuscitation (CPR), cause rib and sternum fractures in around 79% and 54% of patients, respectively. Spinal fractures resulting from CPR are far rarer. We present the case of a 70-year-old man who underwent mechanical CPR after choking whilst eating. The patient received a cerebral and thoracic CT scan upon arrival to the hospital. The cerebral scan was normal, but the chest CT scan revealed signs of ankylosing spondylitis and an unstable Chance fracture of the 12th thoracic vertebra. The patient was hospitalised but passed away. This case highlights the need for awareness of uncommon spine fractures due to the high associated morbidity. Teaching point: In patients who have undergone thoracic compressions, one should not only search for rib fractures but also for spine fractures, which, though uncommon, have a far greater impact on the patient's morbidity, especially in patients with predisposing spine conditions.