The international scientific literature reports no data on the prevalence and effectiveness of back protector devices (BPD). In Italy, no data have been collected on BPD because their use is not mandatory. To fill this gap, the National Institute of Health implemented a cross-sectional study in collaboration with the National Traffic Police.Accident cases were collected from 1 December 2011 to 25 October 2013. Overall, data from 2104 accidents involving 2319 injured subjects were analysed: 1821 (78.5%) of these were motorcyclists and 498 (21.5%) mopedists. The use of Hard-shell BPD or jackets with airbags in motorcyclists is higher then in moped drivers (16.2% vs 1.3%,P¼0.000). Concerning level of protection, there are no differences between drivers and passengers. In most severely injured motorcyclists (i.e. hospitalized or deceased), the percentage of injuries to the spine was lower (13.6%) among those who used a high level safety device (hard-shell BPD and/or airbags) and rose to 27.3% among those who used only protective clothing (P¼0.022). When the variables potentially affecting the results of not using a high-safety device were controlled, a bivariate analysis showed that the odds of serious spinal injury were 2.72 times greater (P¼0.049) and a multivariate analysis showed that they were 2.81 times greater (P¼0.012). This study points out that greater use of BPD could reduce the number of injuries to the spinal column resulting from road traffic accidents involving motorized two-wheeled vehicles.