The authors present the issue of rare causes of retrospinal back pain. Particular attention has been given to abdominal aortic aneurysm--it's clinical picture, diagnostic problems and treatment modes. A retrospective evaluation of 65 operated patients was performed. Diagnostic problems in a 66-year-old patient are also presented: the final diagnosis was determined at the time of surgery, although a low back pain treatment regimen had been formerly applied to this patient. The authors emphasise the frequent occurrence of atypical clinical signs accompanying abdominal aortic aneurysm, frequent correlation with degenerative changes of the spine, and the importance of differential diagnostics in patients with atypical symptoms of low back pain.