A zombie grabs Maria Cruz by the head and twists it. Maria's head is turned around 180 degrees until it faces the camera. The force of the twist is so powerful that her broken spine rips out through the side of her neck. The startling shot was achieved through a combination of practical and digital effects. Makeup head Justin Raleigh explains, "We had a full head that we did face replacement on so it is a likeness of [Ana]. We did a shot of her giving the reaction and starting the twist. Then we did the insert element, which is basically a half torso that had the full head and neck element that you could spin and snap and see the bone pop through. And then we had a prosthetic that we put on her that gives the illusion that she spun around and has the bone sticking out of her. So it's three elements with some VFX compositing for the face replacement." Dave Bautista character Scott Ward pauses for one last look at Maria's body lying on the vault floor, her head twisted completely around. To create the effect, Justin says, "We actually sculpted part of the neck to look like it was part of her back to cover her bust and everything in front. And that gave the illusion that she had been spun around."

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