黃韌帶是以彈性纖維與膠原纖維作為其主要的細胞外基質，尤其彈性纖維的佔比是所有韌帶中最高的，所以是以黃韌帶著稱。黃韌帶的主要作用是限制脊柱過度屈曲，穩定並保護著脊柱。隨著年齡的增長，黃韌帶的彈性與柔韌性不如以往，要延緩其退化，了解黃韌帶的發病機制非常重要。
本論文主要在探討黃韌帶在機械應力下引起機械性質和組織成分的改變，利用奈米壓痕儀測得黃韌帶之彈性折合模數、表面硬度和黏彈性，而Tan-Delta 表示黏彈性材料的滯後現象，以及利用拉曼光譜學對黃韌帶的組織成分進行定量分析，特別是與纖維化、軟骨化、鈣化和骨化相關的化學成分的變化，闡明黃韌帶的組織成分對生物力學的影響。為了提升實驗數據的可信度，將實驗數據與臨床厚度做迴歸分析，以了解黏彈性與厚度之間是否具備相關性。除了分析組織成分外，亦用其他依據來輔助判斷黃韌帶退化的嚴重程度，如多光子顯微技術、影像學表現的分析與臨床問卷之回饋，用以協助醫生進行初步診斷，以更省時的方式為患者做出臨床診斷。
綜觀所有實驗可以得到以下數個結論，黃韌帶從背側開始退化，背側的彈性纖維會先行變性，這與文獻上的結論相同。當膠原纖維生成豐富的狀況下，彈性折合模數與表面硬度會上升，損失模數下降導致黏彈性降低。再透過黃韌帶的組織成分與生物力學做迴歸分析，由於黃韌帶退化，產生大量I 型和III 型膠原纖維，而I 型和III 型膠原纖維中的鍵結中以酰胺I表現出的鍵結強度最強，因此膠原結構的變化的主要可能是造成粘彈性改變的重要因素。通過臨床常見之消炎止痛藥如選擇性第二型環氧合酶抑製劑可抑制纖維化，從文獻中可知它能成為改善黃韌帶黏彈性之治療手法，防止韌帶進一步退化。其他輔助醫生臨床判斷的方法如多光子顯微成像和動態滑移可以作為黃韌帶退化的依據。至於臨床問卷，隨著退化程度的加劇，平均歐式失能量表的得分略有增加，得分越高表明患者對日常生活能力受到背痛影響的程度越高；平均身體機能指數下降，得分越低表明患者無法自主生活的程度越高。

The ligamentum flavum is mainly composed of elastic fibers and collagen fibers as the main extracellular matrix, especially the proportion of elastic fibers is the highest among all ligaments, so it is known as the ligamentum flavum. The main function of the ligamentum flavum is to limit the excessive flexion of the spine, stabilize and protect the spine. With aging, the elasticity and flexibility of the ligamentum flavum is not as good as before. To delay its degeneration, it is very important to understand the pathogenesis of the ligamentum flavum.
This thesis mainly discusses the changes of mechanical properties and tissue composition of the ligamentum flavum caused by mechanical stress. The reduced elastic modulus, surface hardness and viscoelasticity of the ligamentum flavum were measured by nanoindentation instrument, and Tan-Delta indicates the hysteresis of viscoelastic materials; the tissue compositions of the ligamentum flavum was quantitatively analyzed by Raman spectroscopy, especially the changes of the chemical composition related to fibrosis, chondrometaplasia, calcification and ossification. To elucidate the biomechanical influence of the tissue composition of the ligamentum flavum. In order to improve the credibility of the experimental data, regression analysis was performed on the experimental data and clinical thickness to understand whether there is a correlation between viscoelasticity and thickness. In addition to the analysis of tissue compositions, other evidences are also used to assist in judging the severity of ligamentum flavum degeneration, such as multiphoton microscopy, analysis of radiology and feedback from clinical manifestations, to assist doctors in making an initial diagnosis and save time to make a clinical diagnosis for the patient.
Looking at all the experiments, the following conclusions can be drawn. The ligamentum flavum degenerates from the dorsal side, and the elastic fibers on the dorsal side will degenerate first, which is the same conclusion as mentioned in the literature. When collagen fibers are abundantly produced, the reduced elastic modulus and surface hardness increase, and the loss modulus decreases, resulting in a decrease in Tan-Delta. Through the regression analysis of the tissue compositions and biomechanics of the LF, a large number of type I and type III collagen fibers are produced due to the degeneration, and among the bonds in type I and type III collagen fibers, amide I exhibits the strongest bond strength, so the change of collagen structure may be an important factor causing the change of viscoelasticity. Common clinical anti-inflammatory and analgesic drugs such as selective COX-2 inhibitors can inhibit fibrosis. It is known from the literature that it can be a treatment method to improve the viscoelasticity of the ligamentum flavum and prevent further degeneration of the ligamentum flavum. Other methods to assist doctors in clinical judgment, such as multiphoton microscopy and dynamic slip, can be used as the basis for ligamentum flavum degeneration. As for the clinical questionnaires, as the degree of degeneration intensified, the score of the mean Oswestry Disability Index increased slightly, with higher scores of the mean Oswestry Disability Index indicating a greater impact of back pain on patients' activities of daily living; the score of the mean physical function decreased, with lower scores of the mean physical function indicating a greater degree of inability to live independently.

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