For a large knife to be worn small of the back (SOB) I really like a pancake design. It lays very flat against the body, comfortable, even in a vehicle, holds the knife well and is accessible. And with this design you are "splitting" the belt loops (belt though one slot of the sheath, through the belt loop and then through the last slot of the sheath) so the measurements of the belt loops aren't as critical as they could be with other designs. But I often see some of my other designs, never intended that way, worn in the back too:
Here is a SOB pancake. Lisa could be a model for us. We made her sandwashed silk wildrag (scarf), her water buffalo belt, holster, knife and sheath and her charmitas (leggings).
And her husband Troy also carries his knife that way too. He carries my Sonoran Camp Knife, the largest knife I make outside of the occasional bowie.
Our friend Emma helps on the ranch and in the shop too sometimes. She prefers to carry that way as well:
Salty helps a lot on the ranch too. He wears one of my Horizontal Sheaths designed to be worn crossdraw, upside down and backwards on his chinks (short chaps or leggings) belt:
These young ladies were part of the staff putting on this show. They were both wearing my knives and stopped by our booth to say howdy:
And "Brother" Bill, our ranch cook also carries that way:
Handy for checking the steaks:
If you are unfamiliar with pancake style sheath construction here is a link to a tutorial I did a few years back on how to make one, (in the stickies in Sheaths and Such):
https://www.bladeforums.com/threads/pancake-sheaths-and-how-i-go-about-them-pic-heavy.1262927/
Hope this helps and I'll sure answer any questions ya might have.