Caspase-9　(CASP-9)　is　an　initiator　caspase　protease　for　apoptosis,　and　plays　an　important　role　in　the　development　and　progression　of　lumbar　disc　disease　(LDD).　The　expression　and/or　activity　of　CASP-9　are　significantly　enhanced　in　the　degenerated　disc.　The　polymorphism　in　the　promoter　region　of　CASP-9　enhances　the　transcriptional　activity　of　this　gene,　thereby　modulating　the　susceptibility　to　LDD.　The　current　study　investigated　the　relationship　between　the　CASP-9　-1263A/G　(rs4645978)　and　-712C/T　(rs4645981)　polymorphisms　and　discogenic　low　back　pain　(LBP).　The　CASP-9　-1263A/G　and　-712C/T　genotypes　in　this　study　were　defined　by　polymerase　chain　reaction　in　154　patients　with　discogenic　LBP　and　216　controls　that　were　frequency-matched　by　age,　gender,　and　occupation.　The　results　showed　that　the　CASP-9　-1263　GG　genotype,　compared　with　the　AA　and　AG　genotypes　[odds　ratio　(OR)　=　1.997,　95%　confidence　interval　(95%　CI)　=　1.216-3.279,　p　=　0.006]　or　the　AA　genotype　(OR　=　2.760,　95%　CI　=　1.464-5.203,　p　=　0.002),　is　associated　with　a　significant　increased　risk　of　discogenic　LBP,　but　the　-712　TT　or　TT　and　CT　genotypes　do　not　contribute　to　discogenic　LBP　compared　with　the　CC　genotype　(OR　=　0.547,　95%　CI　=　0.200-1.494,　p　=　0.234　and　OR　=　0.669,　95%　CI　=　0.439-1.021,　p　=　0.062,　respectively).　These　results　indicated　that　the　CASP-9　-1263A/G　polymorphism　is　associated　with　a　high　risk　of　discogenic　LBP.