{"id":3314,"date":"2014-07-13T15:52:00","date_gmt":"2014-07-13T12:52:00","guid":{"rendered":"https:\/\/scevos.gr\/?p=3314"},"modified":"2025-03-30T16:07:06","modified_gmt":"2025-03-30T13:07:06","slug":"artikull-nga-dr-skevos-poullas-mbi-dhimbjen-e-shtylles-kurrizore-dhe-trajtimin-efektiv-te-saj-ne-faqen-quality-in-health","status":"publish","type":"post","link":"https:\/\/scevos.gr\/sq\/artikull-nga-dr-skevos-poullas-mbi-dhimbjen-e-shtylles-kurrizore-dhe-trajtimin-efektiv-te-saj-ne-faqen-quality-in-health\/","title":{"rendered":"Artikull nga Dr. Skevos Poullas mbi dhimbjen e shtyll\u00ebs kurrizore dhe trajtimin efektiv t\u00eb saj n\u00eb faqen Quality in Health"},"content":{"rendered":"

Shpina e njeriut sfidon gravitetin dhe k\u00ebshtu arrihet ecja me dy k\u00ebmb\u00eb. P\u00ebr m\u00eb tep\u00ebr, funksionon si kanal-mbrojt\u00ebs p\u00ebr strukturat nervore, si vin\u00e7 p\u00ebr ngritje, por edhe si sistem i p\u00ebrshtatsh\u00ebm p\u00ebr ecje t\u00eb qet\u00eb dhe t\u00eb papenguar.<\/p>\n

Megjithat\u00eb, me kalimin e mosh\u00ebs, ajo p\u00ebson efekte – d\u00ebmtim t\u00eb veprimit t\u00eb gravitetit (pesh\u00eb trupore) dhe ngarkes\u00eb biomekanike p\u00ebrmes ndryshimeve strukturore dhe neurokimike, duke rezultuar n\u00eb dhimbje dhe d\u00ebmtime funksionale q\u00eb shpesh ndodhin me ndikim n\u00eb jet\u00ebn dhe pun\u00ebn e p\u00ebrditshme, si dhe \u00e7rregullime t\u00eb elementeve nervore si rezultat i presionit ose bllokimit t\u00eb tyre, disa me efekte shkat\u00ebrruese t\u00eb seurmani.<\/p>\n

Dhimbja e shtyll\u00ebs kurrizore (dhimbja kurrizore) \u00ebsht\u00eb shpesh multifaktoriale me parametra t\u00eb shumansh\u00ebm t\u00eb p\u00ebrfshir\u00eb q\u00eb p\u00ebrfshijn\u00eb faktor\u00eb t\u00eb till\u00eb si ndikimet strukturore (strukturat anatomike), biomekanike, biokimike, jatrogjene dhe psikosociale. E m\u00ebsip\u00ebrme shpesh \u00e7on n\u00eb dilema diagnostike dhe terapeutike aq komplekse sa trajtimi shpesh p\u00ebrfundon t\u00eb jet\u00eb i v\u00ebshtir\u00eb ose joefektiv. [1,2]<\/p>\n

P\u00ebr sa i p\u00ebrket dhimbjeve t\u00eb shtyll\u00ebs kurrizore, p\u00ebrve\u00e7 dhimbjeve spondilogjene (dhimbje p\u00ebr shkaqe muskulo-skeletore), ka edhe dhimbje nga element\u00ebt nervor\u00eb t\u00eb zon\u00ebs. S\u00eb fundi, ndonj\u00ebher\u00eb dhimbja \u00ebsht\u00eb refleksive ose p\u00ebr shkak t\u00eb kushteve m\u00eb t\u00eb p\u00ebrgjithshme. M\u00eb konkretisht, p\u00ebr dhimbjet e shpin\u00ebs (dhimbjet e mesit) dhe dhimbjet e nervit shiatik (dhimbjet p\u00ebrgjat\u00eb nervit shiatik n\u00eb k\u00ebmb\u00eb), shkaqet jan\u00eb multifaktoriale dhe mund t\u00eb jen\u00eb p\u00ebr shkak t\u00eb d\u00ebmtimit t\u00eb diskut nd\u00ebrvertebral, inflamacionit t\u00eb diskut ose vertebr\u00ebs, tumoreve [primare ose metastatike], traumave akute ose traumave t\u00eb mbip\u00ebrdorimit, stenoz\u00ebs spinale spinale ose \u00e7rregullimeve t\u00eb theksit spinal biaksi. Gjithashtu, s\u00ebmundjet m\u00eb t\u00eb p\u00ebrgjithshme si fibromialgjia (dhimbje difuze muskulo-skeletore – pika t\u00eb shumta t\u00eb tendosjes, \u00e7rregullime t\u00eb gjumit etj.), osteoporoza dhe s\u00ebmundjet reumatizmale (spondiloartropatit\u00eb seronegative etj.) manifestohen me p\u00ebrfshirjen e ky\u00e7eve sakroiliake dhe dhimbje n\u00eb zon\u00eb. [3]<\/p>\n

Paralelisht me \u00e7do dhimbje t\u00eb shtyll\u00ebs kurrizore, dhimbje reflekse nga organet e brendshme (pankreatiti – kolecistiti, perikarditi, pleuriti, pneumonia, s\u00ebmundjet e brinj\u00ebve dhe sternumit, nefrolitiaza, pielonefriti, prostatiti) si dhe s\u00ebmundjet e ijeve dhe t\u00eb indeve t\u00eb buta muskulore jo-speciale ed dhe p\u00ebr k\u00ebt\u00eb arsye p\u00ebrjashtohen. [3]<\/p>\n

K\u00ebshillohet gjithashtu t\u00eb p\u00ebrjashtohen dhimbjet e shpin\u00ebs nga aneurizma e aort\u00ebs (e manifestuar me dhimbje barku ose mesit dhe nj\u00eb mas\u00eb pulsuese, nd\u00ebrkoh\u00eb q\u00eb shpesh v\u00ebrehen dhimbje kronike t\u00eb shpin\u00ebs) [4], dhimbjet e shpin\u00ebs n\u00eb stomak dhe kancer pankreatik q\u00eb manifestohet me simptoma t\u00eb shtyll\u00ebs kurrizore p\u00ebrve\u00e7 simptomave t\u00eb tretjes [5], si dhe n\u00eb kraharorin, q\u00eb manifestohet, nd\u00ebr t\u00eb tjera, me aneurit\u00eb e aort\u00ebs. [6]<\/p>\n

Duke marr\u00eb parasysh t\u00eb gjitha sa m\u00eb sip\u00ebr, mjeku kurues do t\u00eb jet\u00eb n\u00eb gjendje t\u00eb dalloj\u00eb dhimbjen specifike (me nj\u00eb etiologji t\u00eb qart\u00eb t\u00eb nj\u00ebr\u00ebs prej m\u00eb sip\u00ebr) nga dhimbjet jo specifike t\u00eb shpin\u00ebs (n\u00eb t\u00eb cilat simptomat nuk mund t’i atribuohen qart\u00eb nj\u00eb shkaku specifik) dhe duhet t\u00eb jet\u00eb n\u00eb gjendje t\u00eb p\u00ebrjashtoj\u00eb fraktur\u00ebn e tumorit, inflamacionin mikrobial ose simptomat neurologjike – ve\u00e7an\u00ebrisht sindrom\u00ebn e dhimbjes s\u00eb kofsh\u00ebs, s\u00ebmundjet q\u00eb k\u00ebrkojn\u00eb trajtim t\u00eb menj\u00ebhersh\u00ebm t\u00eb m\u00ebtejsh\u00ebm. [7]<\/p>\n

P\u00ebr sa i p\u00ebrket v\u00ebshtir\u00ebsis\u00eb s\u00eb shpesht\u00eb t\u00eb atribuimit t\u00eb dhimbjes n\u00eb nj\u00eb struktur\u00eb anatomike p\u00ebr t\u00eb arritur trajtimin e duhur, nj\u00eb shembull klasik \u00ebsht\u00eb ai i dhimbjes s\u00eb shpin\u00ebs q\u00eb vjen nga degjenerimi i diskut nd\u00ebrvertebral. Duhet t\u00eb kihet parasysh se \u00ebsht\u00eb e mundur t\u00eb v\u00ebzhgohet patologjia e diskut n\u00eb imazhe edhe tek individ\u00ebt asimptomatik\u00eb. [bazuar n\u00eb informacionin e nj\u00eb artikulli mjek\u00ebsor (q\u00eb n\u00eb vitin 1990) q\u00eb kishte t\u00eb b\u00ebnte me ekzaminimin e shtyll\u00ebs s\u00eb qaf\u00ebs s\u00eb mitr\u00ebs me MRI t\u00eb 63 pacient\u00ebve asimptomatik\u00eb, n\u00eb 19% t\u00eb pacient\u00ebve asimptomatik\u00eb, anomalit\u00eb e diskut u gjet\u00ebn me MRI (14%<40 vje\u00e7 & 28%>40)] [8,9]<\/p>\n

Lidhur me epidemiologjin\u00eb dhe ndikimin ekonomik t\u00eb dhimbjes s\u00eb shpin\u00ebs, ekspert\u00ebt kan\u00eb vler\u00ebsuar se af\u00ebrsisht 80% e amerikan\u00ebve do t\u00eb p\u00ebrjetojn\u00eb dhimbje shpine gjat\u00eb jet\u00ebs s\u00eb tyre. Gjasht\u00ebdhjet\u00eb p\u00ebrqind e njer\u00ebzve q\u00eb vuajn\u00eb nga dhimbja akute e shpin\u00ebs do t\u00eb sh\u00ebrohen n\u00eb 6 jav\u00eb, nd\u00ebrsa deri n\u00eb 80-90% sh\u00ebrohen brenda 12 jav\u00ebsh. Megjithat\u00eb, sh\u00ebrimi i pacient\u00ebve t\u00eb tjer\u00eb me dhimbje shpine \u00ebsht\u00eb m\u00eb pak i sigurt.<\/p>\n

Dhimbja e mesit \u00ebsht\u00eb s\u00ebmundja beninje m\u00eb e shtrenjt\u00eb n\u00eb vendet e industrializuara, nd\u00ebrsa kalimi n\u00eb kronik\u00eb shoq\u00ebrohet me rritje t\u00eb s\u00ebmundshm\u00ebris\u00eb, munges\u00ebs nga puna etj.[3]. Kjo \u00ebsht\u00eb arsyeja pse OBSH-ja gjithashtu e p\u00ebrmend at\u00eb me frazat e m\u00ebposhtme t\u00eb bazuara n\u00eb studime: “Dhimbja e shpin\u00ebs \u00ebsht\u00eb shkaku kryesor i kufizimit t\u00eb aktivitetit dhe munges\u00ebs s\u00eb pun\u00ebs n\u00eb pjes\u00ebn m\u00eb t\u00eb madhe t\u00eb bot\u00ebs, p\u00ebrgjegj\u00ebse p\u00ebr imponimin e nj\u00eb barr\u00eb t\u00eb lart\u00eb ekonomike p\u00ebr individ\u00ebt, familjet, komunitetet, industrit\u00eb dhe qeverit\u00eb”. Disa studime jan\u00eb kryer n\u00eb Evrop\u00eb n\u00eb nj\u00eb p\u00ebrpjekje p\u00ebr t\u00eb vler\u00ebsuar ndikimin social dhe ekonomik t\u00eb dhimbjes s\u00eb mesit. N\u00eb Mbret\u00ebrin\u00eb e Bashkuar, dhimbja e mesit u identifikua si shkaku m\u00eb i zakonsh\u00ebm i paaft\u00ebsis\u00eb tek t\u00eb rinjt\u00eb, me m\u00eb shum\u00eb se 100 milion\u00eb dit\u00eb pune t\u00eb humbura \u00e7do vit, nd\u00ebrsa n\u00eb Suedi, hulumtimi tregoi se dhimbja e mesit ishte p\u00ebrgjegj\u00ebse p\u00ebr nj\u00eb rritje kat\u00ebrfish t\u00eb numrit t\u00eb dit\u00ebve t\u00eb humbura t\u00eb pun\u00ebs nga 7 milion\u00eb n\u00eb 1980 n\u00eb 28 milion\u00eb n\u00eb 1987 (n\u00eb m\u00ebnyr\u00eb t\u00eb ngjashme, ekzistenca e autor\u00ebve social\u00eb mund t\u00eb jet\u00eb nj\u00eb rritje). ,11]<\/p>\n

Nisur nga sa m\u00eb sip\u00ebr, p\u00ebr \u00e7do dhimbje t\u00eb shtyll\u00ebs kurrizore, \u00ebsht\u00eb i nevojsh\u00ebm nj\u00eb diagnoz\u00eb e sakt\u00eb e shkakut dhe e patologjis\u00eb p\u00ebr t\u00eb ndjekur trajtimin korrekt dhe p\u00ebr ta rikthyer m\u00eb tej pacientin n\u00eb gjendjen e m\u00ebparshme sa m\u00eb shpejt t\u00eb jet\u00eb e mundur. Kjo rezulton n\u00eb ulje t\u00eb s\u00ebmundshm\u00ebris\u00eb, nd\u00ebrhyrje t\u00eb panevojshme diagnostike dhe terapeutike dhe p\u00ebrfundimisht zbatimin e trajtimit t\u00eb duhur, ve\u00e7an\u00ebrisht p\u00ebr elementin anatomik t\u00eb prekur.<\/p>\n

Prandaj \u00ebsht\u00eb e r\u00ebnd\u00ebsishme n\u00eb parim<\/p>\n

a.<\/strong>\u00a0\u00a0marrja e nj\u00eb historie t\u00eb p\u00ebrgjithshme t\u00eb detajuar t\u00eb pacientit (simptoma fizike dhe mendore, karakteristikat e dhimbjes, historia familjare, etj.)<\/p>\n

b.<\/strong>\u00a0\u00a0ekzaminimin e detajuar klinik<\/p>\n

c.<\/strong>\u00a0\u00a0mund\u00ebsia ose jo e atribuimit t\u00eb k\u00ebtyre simptomave ose gjetjeve n\u00eb struktura t\u00eb ve\u00e7anta anatomike<\/p>\n

d.<\/strong>\u00a0\u00a0ekzistenca ose mungesa e elementeve nga sfera mendore por edhe ekzistenca e shenjave Waddel[3,4]. K\u00ebto shenja jan\u00eb tregues i nj\u00eb elementi psikologjik t\u00eb dhimbjes kronike t\u00eb shpin\u00ebs, hipokrizis\u00eb etj., t\u00eb cilat duhen konsideruar si duhet n\u00eb kombinim me element\u00eb t\u00eb tjer\u00eb q\u00eb rrjedhin nga historia, vler\u00ebsimi klinik dhe ekzaminimet e tjera paraklinike p\u00ebr t\u00eb mos arritur n\u00eb p\u00ebrfundime t\u00eb gabuara.<\/p>\n

N\u00eb m\u00ebnyr\u00eb t\u00eb detajuar, pas historis\u00eb dhe ekzaminimit klinik, vijon testimi i m\u00ebtejsh\u00ebm laboratorik, i cili p\u00ebrfshin: [3]<\/p>\n

A.<\/strong>\u00a0\u00a0Fillimisht radiografi e thjesht\u00eb (F\/P\/zhdrejt) [n\u00eb pacient\u00ebt >50 vje\u00e7, dhimbje pushimi, trauma apo patologji t\u00eb tjera, tumor, inflamacion etj.] dhe analiza laboratorike n\u00eb rast t\u00eb dyshimit p\u00ebr inflamacion-tumor [3]<\/p>\n

B.<\/strong>\u00a0\u00a0Sidomos n\u00eb rastet e dhimbjeve q\u00eb zgjasin m\u00eb shum\u00eb se 6-12 jav\u00eb pavar\u00ebsisht trajtimit, rekomandohet ekzaminim i m\u00ebtejsh\u00ebm me tomografi t\u00eb kompjuterizuar (CT), ve\u00e7an\u00ebrisht p\u00ebr t\u00eb kontrolluar d\u00ebmtimin e strukturave t\u00eb kockave kortikale (standard ari) ose ku MRI \u00ebsht\u00eb kund\u00ebrindikuar. Rezonanca magnetike aplikohet ve\u00e7an\u00ebrisht p\u00ebr hetimin e indeve t\u00eb buta dhe elementeve nervore ose n\u00eb rastet e dyshimit p\u00ebr inflamacion ose tumor, nd\u00ebrsa ndon\u00ebse prania e nj\u00eb elementi metalik n\u00eb shtyll\u00ebn kurrizore (operacioni i m\u00ebparsh\u00ebm) nuk \u00ebsht\u00eb kund\u00ebrindikacion, ndonj\u00ebher\u00eb prania e tij komplikon vler\u00ebn e tij.[3,13]. S\u00eb fundi, injeksioni i kontrastit n\u00eb kombinim me MRI indikohet p\u00ebr hetimin e patologjis\u00eb postoperative (ngjitjet – niveli i d\u00ebmtimit t\u00eb diskut, etj.) [14]<\/p>\n

N\u00eb rastet e dyshimit p\u00ebr metastaza kockore nga nj\u00eb vend par\u00ebsor, p\u00ebrdoret edhe shintigrafia 3-fazore me Tc 99M. Kjo \u00ebsht\u00eb gjithashtu e dobishme p\u00ebrve\u00e7 ekzaminimit t\u00eb leukocitit Ga67-citrat ose In111 n\u00eb rastet e inflamacionit (spondilodisciti) dhe krahas p\u00ebrdorimit t\u00eb MRI n\u00eb k\u00ebto raste p\u00ebr vler\u00ebsim m\u00eb t\u00eb mir\u00eb [12].<\/p>\n

Nj\u00eb test tjet\u00ebr \u00ebsht\u00eb mielografia ose CTmielografia p\u00ebr t\u00eb kontrolluar kompresimin e nervit (gjer\u00ebsia e kanalit) ose prania e arachnoiditit postoperativ. Diskografia (riprodhimi i dhimbjes me injeksion kontrasti \/ natyra diskogjenike e dhimbjes) \u00ebsht\u00eb gjithashtu e dobishme, si\u00e7 \u00ebsht\u00eb injektimi diagnostik i anestezis\u00eb n\u00eb nyjet vertebrale t\u00eb pasme ose nyjet sakroiliake, q\u00eb p\u00ebrcakton origjin\u00ebn e dhimbjes.<\/p>\n

N\u00eb rastet e dhimbjeve t\u00eb theksuara t\u00eb k\u00ebmb\u00ebs, ndihm\u00eb t\u00eb konsiderueshme japin edhe testet neurofiziologjike (EMG, shpejt\u00ebsit\u00eb e p\u00ebrcjelljes, pletismografia, etj.), pasi identifikon nivelin e dhimbjes dhe p\u00ebrjashton s\u00ebmundjet e tjera neuromuskulare. [3]<\/p>\n

S\u00eb fundi, megjith\u00ebse MRI dhe CT mund t\u00eb zbulojn\u00eb shum\u00eb gjendje patologjike, nuk \u00ebsht\u00eb gjithmon\u00eb e qart\u00eb se me cil\u00ebn nga k\u00ebto kushte lidhen simptomat e pacientit (kryesisht n\u00eb ndryshimet kronike degjenerative t\u00eb shtyll\u00ebs kurrizore). Kirurgjia endoskopike invazive e shtyll\u00ebs kurrizore duke p\u00ebrdorur endoskop\u00eb fleksib\u00ebl na ofron aft\u00ebsin\u00eb p\u00ebr:<\/p>\n

1.\u00a0<\/strong>\u00a0N\u00ebp\u00ebrmjet riprodhimit t\u00eb simptomatologjis\u00eb p\u00ebrcaktoni mas\u00ebn e d\u00ebmtimit (vlera parashikuese pozitive 87%-100%).<\/p>\n

2.\u00a0<\/strong>\u00a0P\u00ebrcaktimi i kanalit spinal dhe i foramin\u00ebs na lejon t\u00eb dallojm\u00eb integritetin anatomik t\u00eb k\u00ebtyre strukturave si dhe t\u00eb dallojm\u00eb m\u00eb mir\u00eb lezionet osteofitike nga ngjitjet ose gjendje t\u00eb tjera patologjike.<\/p>\n

3.\u00a0<\/strong>\u00a0S\u00eb fundmi endoskopia dokumenton diagnoz\u00ebn ton\u00eb por na jep edhe mund\u00ebsin\u00eb e trajtimit t\u00eb nj\u00ebkohsh\u00ebm (ablimi i materialit t\u00eb diskut me Holmium Yag Laser, liza e ngjitjeve, marrja e materialit biopsik dhe hapja e proceseve cistike etj.)<\/p>\n

Metoda e aksesit endoskopik invaziv n\u00eb kanalin spinal ose n\u00eb foramin\u00eb p\u00ebrmes fisur\u00ebs sakrale, pavar\u00ebsisht se \u00ebsht\u00eb diagnostikisht superiore ndaj teknikave t\u00eb zakonshme neuroimazherike (MRI\/CT), kryesisht n\u00eb ndryshimet kronike degjenerative t\u00eb shtyll\u00ebs kurrizore dhe pavar\u00ebsisht se \u00ebsht\u00eb invazive, ka avantazhin e ofrimit t\u00eb diagnoz\u00ebs dhe trajtimit n\u00eb t\u00eb nj\u00ebjtin seanc\u00eb n\u00eb shumic\u00ebn e rasteve.<\/p>\n

Si p\u00ebrfundim, p\u00ebr shkak t\u00eb rritjes s\u00eb s\u00ebmundshm\u00ebris\u00eb, ndikimit n\u00eb cil\u00ebsin\u00eb e jet\u00ebs, munges\u00ebs nga puna, por edhe ngarkes\u00ebs financiare n\u00eb buxhetet e sh\u00ebndet\u00ebsis\u00eb, dhimbja e shtyll\u00ebs kurrizore k\u00ebrkon nj\u00eb diagnoz\u00eb t\u00eb sakt\u00eb me identifikimin e sakt\u00eb t\u00eb elementit strukturor q\u00eb shkakton dhimbjen dhe trajtim efektiv afatshkurt\u00ebr p\u00ebr t\u00eb arritur rezultatin m\u00eb t\u00eb mir\u00eb t\u00eb mundsh\u00ebm.<\/p>\n

\u00a0Bibliografia<\/strong><\/p>\n

1.\u00a0http:\/\/emedicine.medscape.com\/article\/1144130-overview<\/a><\/p>\n

2. Wheeler AH, Murray DB. Dhimbja kurrizore: patogjeneza, mekanizmat evolucionar dhe menaxhimi, n\u00eb Pappagallo M (ed). Baza neurologjike e dhimbjes. Nju Jork: McGraw-Hill; 2005:421-52.<\/p>\n

3.\u00a0\u00a0http:\/\/www.ninds.nih.gov\/disorders\/backpain\/detail_backpain.htm<\/a><\/p>\n

4.\u00a0http:\/\/en.wikipedia.org\/wiki\/Waddell%27s_signs<\/a><\/p>\n

5.\u00a0http:\/\/emedicine.medscape.com\/article\/1979501-clinical<\/a><\/p>\n

6.\u00a0\u00a0http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1121865\/<\/a><\/p>\n

(Kanceri i stomakut dhe pankreasit, BMJ. 15 dhjetor 2001; 323(7326): 1413-1416).<\/p>\n

7.\u00a0\u00a0http:\/\/www.mayoclinic.org\/diseases-conditions\/aortic-aneurysm\/basics\/symptoms\/con-20043547<\/a><\/p>\n

8.\u00a0\u00a0http:\/\/www.bmj.com\/content\/347\/bmj.f7432<\/a><\/p>\n

9. Hatzipaylou A et al. Paschalidis 2006<\/p>\n

10.\u00a0\u00a0http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/2398088<\/a><\/p>\n

11 .\u00a0\u00a0http:\/\/www.who.int\/medicines\/areas\/priority_medicines\/Ch6_24LBP.pdf<\/a><\/p>\n

12\u00a0\u00a0\u00a0https:\/\/www.us.elsevierhealth.com\/media\/us\/samplechapters\/9780323041775\/Chapter%2002.pdf<\/a><\/p>\n

13.\u00a0http:\/\/www.acr.org\/~\/media\/5B165A70F9E342D4B77F0680A573C7ED.pdf<\/a><\/p>\n

14.\u00a0\u00a0http:\/\/www.guideline.gov\/content.aspx?id=35145<\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"

Shpina e njeriut sfidon gravitetin dhe k\u00ebshtu arrihet ecja me dy k\u00ebmb\u00eb. P\u00ebr m\u00eb tep\u00ebr, funksionon si kanal-mbrojt\u00ebs p\u00ebr strukturat nervore, si vin\u00e7 p\u00ebr ngritje, por edhe si sistem i p\u00ebrshtatsh\u00ebm p\u00ebr ecje t\u00eb qet\u00eb dhe t\u00eb papenguar.<\/p>\n","protected":false},"author":1,"featured_media":2869,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[36],"tags":[],"class_list":["post-3314","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"_links":{"self":[{"href":"https:\/\/scevos.gr\/sq\/wp-json\/wp\/v2\/posts\/3314","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/scevos.gr\/sq\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/scevos.gr\/sq\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/scevos.gr\/sq\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/scevos.gr\/sq\/wp-json\/wp\/v2\/comments?post=3314"}],"version-history":[{"count":5,"href":"https:\/\/scevos.gr\/sq\/wp-json\/wp\/v2\/posts\/3314\/revisions"}],"predecessor-version":[{"id":4349,"href":"https:\/\/scevos.gr\/sq\/wp-json\/wp\/v2\/posts\/3314\/revisions\/4349"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/scevos.gr\/sq\/wp-json\/wp\/v2\/media\/2869"}],"wp:attachment":[{"href":"https:\/\/scevos.gr\/sq\/wp-json\/wp\/v2\/media?parent=3314"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/scevos.gr\/sq\/wp-json\/wp\/v2\/categories?post=3314"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/scevos.gr\/sq\/wp-json\/wp\/v2\/tags?post=3314"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}