Pular para o conteúdo
Whatsapp Facebook Youtube Instagram Map-marker-alt Phone-alt

Coluna vertebral: somos referência em tratamentos

    itc vertebral jundiaí

    Para você entender tudo o que acontece com a coluna vertebral, vamos começar por sua forma e sua anatomia. A coluna vertebral é constituída por uma série de ossos, que são chamados de vértebras. Então, vamos conhecer o conjunto de vértebras, que é dividido em quatro regiões, que são:

    • cervical (pescoço), com sete vértebras;
    • torácica (tronco), com doze vértebras;
    • lombar (região da cintura), com cinco vértebras;
    • sacro (região do quadril), com cinco vértebras fundidas;

    O cóccix (ponta final da coluna) tem de quatro a cinco vértebras, também fundidas, já o sacro é a base da coluna vertebral que se articula também com a bacia. Assim, as alterações que ocorrem nessa região poderão trazer muitos problemas para a coluna.

    A coluna vertebral, vista de frente ou de costas, deve ser reta. Quando ela é vista de perfil (lateral), cada região se apresenta com curvatura específica, o que chamamos de lordose ou de cifose.

    É muito comum encontrarmos pessoas com essas linhas acentuadas (hiperlordose ou hipercifose), assim como encontramos também pessoas sem essas curvaturas. Quando isso acontece, chamamos de zonas planas ou com o segmento retificado.

    Divisão da coluna

    Coluna Cervical (C1 a C7) – pescoço

    Na parte alta, encontramos a coluna cervical (pescoço) e suas sete vértebras: Vértebra Cervical 1 (C1), Vértebra Cervical 2 (C2) e, assim, sucessivamente: C3, C4, C5, C6 e C7. Desse conjunto, apenas duas vértebras da coluna cervical não têm um disco intervertebral interposto entre elas: C1 e C2. Nessa região, a curvatura é chamada de lordose cervical. Esse é o segmento de maior mobilidade da coluna vertebral. Quando essas curvaturas não existem ou estão alteradas, isso é sinal de problema postural e geralmente é causa de dores e degeneração dos discos e de vértebras. Esse conceito é aplicado para todo o segmento vertebral; ou seja, essas alterações de curvaturas nas regiões torácica ou lombar provocam as mesmas consequências. A coluna vertebral e os discos aumentam de tamanho e de volume da região cervical para lombar. Portanto, as vértebras e os discos intervertebrais na coluna cervical são os mais estreitos.

    Coluna Torácica (T1 a T12) – tronco

    Na parte média, encontramos a coluna torácica com suas 12 vértebras – de cima para baixo chamamos de Torácica 1 (T1), Torácica 2 (T2) e, assim, sucessivamente, até T12. Temos nessa região 12 pares de costelas, dos quais 7 pares se articulam com o osso esterno (o osso que fica entre o lado direito e o lado esquerdo do peito). São chamadas também de costelas verdadeiras. Outros três pares de costelas se articulam com a cartilagem do esterno – são chamadas de falsas. As duas últimas são flutuantes, pois estão soltas, fixas apenas na porção posterior da coluna vertebral. Elas não se articulam com o esterno.

    A curvatura do segmento torácico é oposta às curvaturas da lombar e cervical – é chamada de cifose torácica. Na pessoa idosa essa região tende a ficar mais proeminente, em virtude de uma fraqueza muscular, desidratação e diminuição dos discos. Sendo assim, idoso tem uma tendência de ficar com o tronco mais curvado para frente e de olhar para baixo, além de uma certa dificuldade respiratória. Essas curvaturas, quando são acentuadas, são chamadas de hipercifose. Por isso, o mais importante é que existem técnicas posturais de fisioterapia que auxiliam o idoso a se manter bem posturado. Devido ao gradil costal, essa região tem pouca mobilidade. Dessa forma, os discos e as vértebras são mais protegidos de lesões.

    Coluna Lombar (L1 a L5) – região da cintura

    Na região baixa, você vai encontrar a coluna lombar com suas cinco vértebras lombares, que são chamadas de Lombar 1 (L1)1, L2 até a Lombar 5 (L5). Essas abreviaturas são encontradas com mais frequência nos laudos dos exames complementares como raio X, tomografias e ressonância nuclear magnética. A sua curvatura é lordótica. Ou seja, essa é a região da coluna que mais recebe carga entre as vértebras. E então, como consequência, é o segmento mais acometido de toda a coluna vertebral. Essa região realiza grandes movimentos de flexão anterior e posterior, um bom movimento de lateralidade e poucos graus de rotação. Por isso, alguns autores descrevem que as curvaturas lordóticas têm como função realizar movimentos, e as curvaturas cifóticas têm como função realizar proteção de órgãos e estruturas nobres do nosso corpo. Por exemplo, a região torácica, com sua cifose, protege os pulmões e o coração.

    Sacro e Cóccix

    No segmento mais inferior da coluna, encontramos o sacro e o cóccix. O sacro tem um papel fundamental na biomecânica da coluna vertebral. Por causa de suas comunicações com os ossos da bacia, ele tem uma função fundamental na nossa postura e determina a angulação da nossa coluna.

    Estamos falando do ângulo formado entre o sacro e cabeça do fêmur, chamado ângulo de incidência pélvica, ele determina o equilíbrio entre o quadril e a coluna vertebral.

    Uma coluna normal tem quatro curvaturas importantes, e para ter uma boa postura, é necessário que estas curvaturas sejam sempre preservadas.

    • Projetada um pouco para frente;
    • Uma curvatura torácica projetada para trás;
    • Uma curvatura lombar projetada para frente;
    • A curvatura do sacro projetada para trás.

    Os discos intervertebrais

    Os discos são estruturas cartilaginosas de pouca vascularização (circulação sanguínea). Eles variam de tamanho, de espessura e de formato; ou seja, suas características variam de acordo com o segmento vertebral. É a estrutura mais afetada da coluna vertebral e a que tem provocado grandes prejuízos para o homem moderno. Os 23 discos estão localizados entre as vértebras. Eles se conectam com as vértebras por meio das placas terminais. Essas placas têm um papel fundamental com o envelhecimento e o desgaste dos discos e vértebras. Portanto, conhecendo esse processo evolutivo, poderemos prevenir muitas dores nas costas. Os discos formam cerca de 25% do comprimento total da coluna. Por isso, o envelhecimento e a desidratação dessas estruturas anatômicas irão provocar diminuição na estatura dos idosos.

    O disco é constituído na sua periferia por um anel fibroso e, na sua parte interna, por uma estrutura ”gelatinosa” chamada de núcleo pulposo. O grande desafio para nós, profissionais da saúde, é saber como prevenir lesões e desgastes nessa estrutura nobre do nosso corpo. Sabemos que a coluna vertebral e seus discos têm como função primária proteger a medula espinhal e suas raízes, e esses desgastes poderão levar a compressões e atritos nessa estrutura neurológica provocando dores e incapacidades indesejadas.

    A medula espinhal

    A medula é uma estrutura cilíndrica que fica dentro do canal vertebral. Ela é a porção alongada do nosso encéfalo. O seu início ocorre entre o crânio e a primeira vértebra cervical e se estende até a primeira ou segunda vértebra lombar. O comprimento pode chegar a 46 centímetros. Na sequência ou depois da segunda vértebra lombar, ela se ramifica – essas ramificações são chamadas de cauda equina.

    Você também vai observar que a medula dá origem a vários pares de nervos, que são no total de 31. Esses nervos saem da coluna vertebral por meio dos orifícios formados entre uma vértebra e outra, também chamados de orifício de conjugação. Por intermédio desses nervos, a medula conduz os impulsos nervosos e exerce funções importantes sobre os músculos, proporcionando os movimentos.

    A medula é envolvida por três membranas que também protegem o encéfalo. São elas: dura-máter, aracnoide e pia-máter, também chamada de meninges. Dentro dessas membranas encontramos líquido cefalorraquidiano, que banha todo o sistema nervoso. Por meio desse líquido, alguns diagnósticos poderão ser efetuados como: meningite, tumores etc. Agora que você entendeu as formas e as estruturas da coluna, os detalhes das vértebras e dos seus discos intervertebrais, ficou fácil perceber que toda essa complexidade anatômica tem uma função primordial, que é proteger a medula espinhal. Tudo foi feito nesse sentido, assim como a caixa craniana protege o nosso cérebro, nós precisávamos de um “tubo” protetor que protegesse a nossa medula espinhal de traumas e compressões.

    Os ligamentos

    Vamos entender agora outra função da coluna vertebral – a de realizar os mais diversos movimentos. Os ligamentos são pequenas estruturas formadas de tecido fibroso que unem um ou mais ossos, dando segurança e estabilidade. Na coluna, eles unem uma vértebra com a outra fazendo parte do conjunto de estruturas que dão estabilidade. Essas estruturas são estáticas; elas não se contraem ou se movimentam de forma voluntária.

    Os ligamentos não têm a capacidade de se contrair partindo de um comando nosso, assim como fazemos com os músculos. Nós não temos controle sobre eles. Por isso, escutamos muito as pessoas falarem que foram operadas de ligamento, pois, uma vez que ele é rompido, dependendo da articulação que ele protege ou estabiliza e do grau da lesão, provavelmente será necessária uma intervenção cirúrgica para que ele volte a proteger e a estabilizar a articulação. Esse fato é muito comum com os ligamentos do joelho, do tornozelo e do ombro.

    Principais ligamentos da coluna

    • Longitudinal anterior
    • Longitudinal posterior
    • Esternocostal intra-articular
    • Costotransversal lateral
    • Costotransversal superior
    • Intertransversal
    • Radiado

    Músculos

    Para entendermos os movimentos que a coluna vertebral realiza, devemos entender a participação dos músculos, como eles se comportam durante o nosso dia a dia e, principalmente, durante as lesões e as dores. Nesse sentido, existem muitos estudos que comprovam que esses músculos ficam fracos e atrofiados após os primeiros episódios de dores e lesões na coluna vertebral.

    Nós temos dois tipos de músculos, basicamente, que agem sobre a coluna vertebral, os mais profundos e os mais superficiais, como também os mais distantes da coluna, que também têm influência na estabilidade. Assim como as pesquisas e suas evidências pontuam o fortalecimento muscular como um dos principais caminhos para manter uma coluna saudável, acreditamos também que um bom trabalho muscular poderá prevenir e remediar o homem dessa epidemia chamada hérnia de disco. O nosso objetivo é fazer com que você tenha a consciência de como os músculos das costas ficam fracos e sem resistência após ou durante as lesões, assim como, em geral, as pessoas têm essa consciência com os músculos das pernas e dos braços.

    Importância de fortalecer os músculos

    Quase todos nós sabemos mensurar quando os músculos do tríceps (aquele conhecido como “músculo do tchau”) estão fracos ou quando a coxa está atrofiada ou fina. É preciso que você entenda que, quando existe ou existiu dor na coluna, ali também se inicia ou se iniciou um processo de atrofia e fraqueza muscular. Dessa forma, essa atrofia ou perda de força não se recupera com a melhora da dor ou dos sintomas. Ou seja, uma vez iniciados os sintomas de dores nas costas, consequentemente começarão as atrofias e as fraquezas musculares. A única maneira de reverter esse quadro é com exercícios específicos para os músculos que protegem a coluna, principalmente os mais profundos e curtos, que são os multífidos.

    Músculos multífidos

    Os músculos mais profundos, também chamados de multífidos, são os responsáveis por boa parte da estabilidade da coluna. As suas características, os formatos e principalmente a sua fisiologia propiciam uma boa fixação e amarração da coluna vertebral. Esses músculos são curtos, realizam em média um ou dois movimentos ao mesmo tempo e as suas fibras musculares são mistas – ou seja, têm mais de uma função. Elas podem realizar movimentos rápidos e forçados e, ao mesmo tempo, são muito resistentes. Outra característica importante é que essas fibras demoram a se fadigar.

    Esses pequenos músculos nos ajudam na manutenção da postura por longos períodos. Além de promover a extensão do tronco, esse músculo proporciona estabilidade posterior para coluna vertebral, nos mantém na posição de pé e é importante para realizar a flexão de tronco. Outros músculos profundos, como os intertransversais, interespinhais, rotadores, paravertebrais e eretores, contribuem com a geração de suporte para a coluna vertebral, mantêm a rigidez e produzem movimentos mais finos no segmento móvel.

    Dinâmica de funcionamento

    O importante é que você saiba que existem esses músculos nas partes mais profundas da coluna e que eles devem ser trabalhados e fortalecidos, assim como os músculos externos que nós podemos ver e palpar. Além disso, você precisa compreender que, quando os músculos profundos se atrofiam, o corpo solicita que outros músculos entrem em ação para suprir a deficiência dos que ficaram fracos. Aí, entram os músculos superficiais, também chamados de dinâmicos. São músculos longos e largos, tendo como função principal realizar os movimentos do nosso corpo.

    Ao contrário dos músculos profundos, eles se fatigam e se cansam com facilidade. Portanto, podemos concluir rapidamente que os músculos da dinâmica não poderão substituir os músculos estáticos (profundos), e, quando isso, ocorre provavelmente teremos dores nas costas. Se os músculos dinâmicos (longos e superficiais) tentam substituir os estáticos (curtos e profundos) e não conseguem, por ficarem fatigados, isso significa que eles ficarão em espasmo, tensos, endurecidos, com pouca circulação sanguínea, em estado de tensão e dor.

    É preciso deixar claro que as consequências desses músculos trabalhando constantemente em espasmos e contrações involuntária serão catastróficas para as vértebras e os discos. Eles agem no sentido de comprimir os segmentos vertebrais, provocando dores e sequelas irreversíveis.

    Parte interna da coluna

    Já é possível observar que a parte interna da coluna é muito rica de tecido nervoso, de cartilagem, de tecido fibroso, de ligamentos e músculos. Porém, não conseguimos ver nem palpar. Também podemos perceber que as articulações da coluna são diferentes das outras, principalmente das grandes como ombro, joelho, tornozelo etc. Primeiro, são vários ossos empilhados. Depois, encontramos várias “juntas”, com possibilidade de movimentos associados e variados que são guiados e executados por um emaranhado de cápsula, ligamentos, tendões e músculos.

    Sendo assim, temos que ser imperativos no que diz respeito ao fortalecimento dos músculos das costas: devemos fortalecer os músculos profundos e próximos da coluna, como também os externos. Sendo assim, temos duas frentes de trabalho: uma mais simples, que é fortalecer os grandes músculos externos, que facilmente são trabalhados nas salas de musculação e pilates, mas, em grande parte, sem critérios técnicos para as pessoas que sofrem ou sofreram de dores nas costas. Se esses grandes músculos estiverem em estado de tensão ou em espasmo, eles não devem ser trabalhados e muito menos fortalecidos. O correto é indicar para uma reeducação postural no intuito de devolver o equilíbrio pélvico e de relaxar músculos e fáscias.

    Além disso, outro grande problema é a segunda frente de trabalho, ou melhor, a técnica para fortalecer os músculos mais internos. É preciso a pessoa passar por uma escala de aprendizado, realizar algumas sessões de treinamento individual para primeiro identificar esses músculos, conseguir senti-los, perceber como são ativados e, em seguida, aprender a fortalecê-los. A população portadora de dores nas costas deve sempre solicitar dos seus fisioterapeutas e profissionais de educação física esse programa de treinamento.

    O corpo humano

    Na engenharia e nas obras da construção civil, toda coluna precisa de uma sapata, de um alicerce. Essa estrutura deve ser reforçada para receber a carga da casa ou do prédio. No corpo humano, não é diferente. A “sapata” da coluna vertebral é o nosso sacro, a bacia – com uma grande diferença: nós temos vida, nós nos movimentamos.

    Portanto, a nossa “sapata” necessita de “fios” e ”cabos” que controlem e estabilizem as nossas infinitas variações de movimentos. Estamos falando dos músculos, tendões e ligamentos que cercam a nossa bacia, o nosso sacro, principalmente os músculos transversais, como foi visto antes. Fortalecer esse conjunto de músculos que envolve o sacro e o quadril é um grande desafio, pois a forma como eles são exercitados poderá ter ações benéficas ou catastróficas.

    Ou seja, poderá gerar estabilidade ou dores por meio de compressões na coluna vertebral. Dependendo da posição ou do aparelho em que executamos determinados exercícios, a ação muscular será compressiva, ela poderá fazer uma aproximação de uma vértebra contra a outra, gerando, assim, pressões nos discos e articulações. Isso acontece quando não estamos bem posturados para fazer algum exercício físico ou mesmo para realizarmos tarefas do nosso dia a dia.

    O que queremos mostrar para a população é que existe na coluna vertebral uma série de compartimentos e de músculos que obrigatoriamente temos de reabilitar e fortalecer de forma específica para termos uma coluna saudável. Para isso, os músculos exigem um grau de cuidado especial. Desta forma eles poderão dar uma boa resposta para o que queremos. É preciso ter muito critério na escolha da academia, do estúdio de pilates, empresa ou profissional que irá realizar o diagnóstico, a avaliação ou orientação dos seus exercícios. É muito comum ouvirmos de pacientes que tiveram dores e crises oriundas de exercícios mal elaborados em academias, salas de treinamento funcional e estúdio de pilates. Por isso, vale lembrar: o mais importante tratamento para doenças degenerativas da coluna é o programa de fortalecimento muscular e de manutenção dos exercícios.

    Tratamento não cirúrgico para a Coluna Vertebral

    O ITC Vertebral desenvolveu uma técnica de tratamento para a coluna vertebral sem procedimentos invasivos. Os pacientes são tratados de acordo com os sintomas e sinais da dor. Então não existe um trabalho padrão, e é aí que consiste um dos grandes diferenciais do ITC Vertebral: o indivíduo passa por uma avaliação criteriosa, sendo direcionado, a partir dessa primeira etapa, para um atendimento personalizado. Fala-se, portanto, em “Subclassificação” das dores na coluna vertebral, os critérios de tratamento obedecem às características individuais do estado clínico do paciente.

    Esse trabalho é baseado numa pesquisa científica que foi iniciada em 1995 em Pittsburg, EUA, depois foi revisada em 2005 e 2010 por Jullie Fritz e publicada nos principais jornais e revistas científicas do mundo. A pesquisa identificou que para cada tipo de dor existem diretrizes de tratamento a serem seguidas, ou seja, as manifestações dolorosas são classificadas e recebem tratamento específico, podendo ser: manipulação ou mobilização articular; a mesa de tração; exercícios direcionais; a estabilização segmentar vertebral e a estabilização dinâmica, que atuam fortalecendo a musculatura profunda da coluna. Esses são os quatro caminhos preconizados pela pesquisa de subclassificação.

    Nosso know-how

    O ITC Vertebral incorporou a devida pesquisa ao trabalho clínico e acrescentou à subclassificação os exercícios e o acompanhamento ao paciente no pós-tratamento. A atenção especial ao pós-tratamento (com um programa completo de fortalecimento muscular) é em virtude de um caráter degenerativo das lesões na coluna, que não têm cura. O tempo de duração do programa de tratamento não é prolongado, em dois meses são obtidos 87% de bons resultados até em pacientes mais graves.

    Assim como o embasamento científico, todos os mais de 236 fisioterapeutas da rede apresentam uma excelente formação técnica com experiências clínicas que capacitam o profissional a atender às demandas individuais dos pacientes.

    Entre em contato conosco!

    (11) 4805 – 4656


    (11) 97090 – 4410

    12.976 comentários em “Coluna vertebral: somos referência em tratamentos”

    3. Gwenda Maciejczyk

      Usually I don’t read post on blogs, but I wish to say that this write-up very forced me to check out and do so! Your writing style has been amazed me. Thank you, quite nice article.

    5. Carmen Zeisler

      I got what you intend, thankyou for posting .Woh I am delighted to find this website through google. “If one does not know to which port one is sailing, no wind is favorable.” by Seneca.

    10. Bryan Bougie

      Some really nice and utilitarian information on this internet site, likewise I think the pattern holds great features.

    13. Marilyn

      Hello there, You have done an incredible job. I will
      definitely digg it and personally suggest to my friends.
      I’m sure they’ll be benefited from this website.

    15. Arlette

      You have made some good points there. I checked on the net to
      find out more about the issue and found most people will go along with your views on this site.

    16. Belle

      Howdy! I could have sworn I’ve been to this blog before but after
      browsing through some of the post I realized it’s new to me.
      Nonetheless, I’m definitely delighted I found it and I’ll be book-marking and checking back often!

    17. Ezra

      whoah this weblog is fantastic i like studying your posts. Stay up the
      good work! You recognize, a lot of people are hunting round for this info, you could help them
      greatly.

    18. Janeen

      Hello are using WordPress for your blog platform?
      I’m new to the blog world but I’m trying to get started and set up my own. Do you need any html coding expertise
      to make your own blog? Any help would be greatly appreciated!

    19. Mitchel

      Hey there would you mind stating which blog platform you’re
      using? I’m going to start my own blog in the near future but I’m having
      a hard time making a decision between BlogEngine/Wordpress/B2evolution and Drupal.
      The reason I ask is because your design seems different then most blogs
      and I’m looking for something unique. P.S My apologies for
      getting off-topic but I had to ask!

    23. Jannie

      Hello just wanted to give you a quick heads up and let you know a few of the
      pictures aren’t loading properly. I’m not sure why but I think
      its a linking issue. I’ve tried it in two different web browsers and both show the same outcome.

    24. Julian

      Oh my goodness! Amazing article dude! Thanks, However I am experiencing problems with your RSS.
      I don’t understand the reason why I am unable to join it.

      Is there anybody having identical RSS issues? Anybody who knows the solution will you kindly respond?

      Thanks!!

    26. Kristeen

      I was wondering if you ever considered changing the layout of your website?

      Its very well written; I love what youve got to say. But maybe you could a little more in the way
      of content so people could connect with it better. Youve got an awful lot
      of text for only having 1 or two pictures.
      Maybe you could space it out better?

    28. Henrietta

      Hi, i think that i noticed you visited my site thus i got here to go back the want?.I’m trying to
      in finding issues to improve my website!I assume its adequate to use some of your ideas!!

    30. Rosie

      I used to be suggested this blog via my cousin. I’m now not
      sure whether or not this submit is written via him as nobody else recognize such specific about my trouble.
      You are wonderful! Thanks!

    33. Kristopher

      After checking out a few of the articles on your web site, I really appreciate your technique of writing a blog.
      I saved as a favorite it to my bookmark webpage list and will be checking
      back soon. Please check out my website too
      and tell me what you think.

    34. Mildred

      I seriously love your website.. Pleasant colors
      & theme. Did you develop this amazing site yourself? Please reply
      back as I’m wanting to create my own website and would like to learn where you got
      this from or what the theme is called. Cheers!

    35. Galen Schoenemann

      Hi, Neat post. There’s a problem with your website in web explorer, may test this… IE nonetheless is the market leader and a big component to other folks will leave out your excellent writing because of this problem.

    36. Bettina

      Hello very nice web site!! Guy .. Excellent .. Superb ..
      I will bookmark your website and take the feeds also?
      I am satisfied to find numerous useful info here within the submit, we need develop more strategies on this regard,
      thank you for sharing. . . . . .

    40. Melisa

      With havin so much content do you ever run into
      any issues of plagorism or copyright violation? My blog
      has a lot of completely unique content I’ve either created myself or outsourced but it looks like a lot of
      it is popping it up all over the web without my agreement.
      Do you know any ways to help stop content from being stolen?
      I’d genuinely appreciate it.

    41. Gisele

      Fantastic beat ! I would like to apprentice while you amend your website,
      how can i subscribe for a blog site? The account aided me a acceptable deal.
      I had been tiny bit acquainted of this your broadcast provided bright clear idea

    42. Jermaine

      Good day! This is kind of off topic but I need some help from an established blog.
      Is it difficult to set up your own blog? I’m not very techincal but
      I can figure things out pretty quick. I’m thinking about creating my
      own but I’m not sure where to begin. Do you have any tips or suggestions?

      Cheers

    43. Scott

      Wow that was strange. I just wrote an extremely long comment but after I clicked submit my comment
      didn’t show up. Grrrr… well I’m not writing all that over
      again. Anyway, just wanted to say superb blog!

    44. Hazel

      I know this if off topic but I’m looking into starting my own blog and was wondering what all is
      needed to get set up? I’m assuming having a blog like
      yours would cost a pretty penny? I’m not very internet savvy so I’m not 100% certain. Any
      tips or advice would be greatly appreciated.
      Thank you

    45. Mitchel

      Hello! I know this is somewhat off topic but I was
      wondering which blog platform are you using for this site?

      I’m getting fed up of WordPress because I’ve had problems with hackers
      and I’m looking at options for another platform.
      I would be fantastic if you could point me in the direction of a good platform.

    46. Otilia

      I’m not that much of a online reader to be honest but your blogs really nice,
      keep it up! I’ll go ahead and bookmark your site
      to come back later. All the best

    47. Glory

      Hey, I think your blog might be having browser compatibility issues.
      When I look at your blog in Ie, it looks fine but when opening in Internet Explorer, it has some overlapping.
      I just wanted to give you a quick heads up! Other then that, fantastic blog!

    48. Leonora

      Your style is very unique compared to other folks I’ve read
      stuff from. Thanks for posting when you have the opportunity, Guess I will just bookmark this blog.

    49. Mona

      My spouse and I stumbled over here by a different web address and thought I might check things out.
      I like what I see so i am just following you.
      Look forward to looking into your web page repeatedly.

    50. Wendy

      Hey there I am so delighted I found your website, I really found you by mistake, while I was looking on Bing
      for something else, Anyhow I am here now and would just like
      to say cheers for a incredible post and a all round thrilling
      blog (I also love the theme/design), I don’t have time to browse
      it all at the minute but I have bookmarked
      it and also added your RSS feeds, so when I have time I will be
      back to read a great deal more, Please do keep
      up the excellent jo.

    52. drive.google.com

      Great blog you have here but I was curious if you knew of any user discussion forums that cover the same topics discussed here?
      I’d really love to be a part of group where I can get comments from other knowledgeable individuals that share the same interest.

      If you have any suggestions, please let me know. Thank you!

    53. Wilhemina

      Thanks for the auspicious writeup. It in reality was once a leisure account it.

      Glance advanced to more delivered agreeable from you!
      However, how can we be in contact?

    55. Jacki

      What i don’t understood is in fact how you are now not actually a lot more
      smartly-preferred than you might be now. You are so intelligent.
      You recognize therefore significantly in relation to this topic, produced
      me in my opinion consider it from a lot of various angles.
      Its like men and women are not interested unless it is
      one thing to accomplish with Lady gaga! Your personal stuffs
      outstanding. All the time care for it up!

    56. Wendell

      Undeniably imagine that that you said. Your favourite reason seemed to be on the net the
      simplest thing to keep in mind of. I say to you, I definitely get
      irked even as other folks think about concerns that they just don’t recognise about.
      You controlled to hit the nail upon the highest as smartly as defined out the whole thing with no need
      side effect , folks can take a signal. Will probably be back to get more.
      Thanks

    57. Nereida

      Just wish to say your article is as astounding.
      The clarity to your submit is just great and i can suppose you are knowledgeable in this subject.
      Well together with your permission allow me
      to grasp your feed to stay updated with imminent post.
      Thank you 1,000,000 and please carry on the enjoyable work.

    58. Corey

      I seriously love your blog.. Very nice colors & theme.
      Did you build this site yourself? Please reply back as I’m attempting to create my very
      own website and would like to find out where you got this from or exactly what the theme is
      named. Cheers!

    62. Crystle

      Hi! I’m at work browsing your blog from my new apple iphone!

      Just wanted to say I love reading your blog and look forward
      to all your posts! Carry on the fantastic work!

    63. Joanna

      I don’t know whether it’s just me or if everyone else experiencing issues with your website.
      It looks like some of the text within your posts are
      running off the screen. Can somebody else please provide feedback
      and let me know if this is happening to them too? This may be a issue
      with my internet browser because I’ve had this happen before.
      Cheers

    65. Carina

      Hey I am so thrilled I found your blog, I really found you by mistake,
      while I was looking on Google for something else, Anyhow
      I am here now and would just like to say thanks for a tremendous post and a all round entertaining blog (I also love the theme/design), I don’t have time to browse it all at the minute but I
      have book-marked it and also added in your RSS feeds, so when I have time I
      will be back to read much more, Please do keep up the great work.

    66. Maximo

      When I initially commented I clicked the “Notify me when new comments are added” checkbox and now each time
      a comment is added I get four e-mails with the
      same comment. Is there any way you can remove people from that
      service? Cheers!

    70. Jamison

      I don’t even know the way I ended up right here, however I assumed this put up was once great.

      I don’t understand who you’re however definitely you are going to a well-known blogger if you happen to are not already.

      Cheers!

    72. Athena

      I don’t know if it’s just me or if perhaps everybody else experiencing problems with your
      site. It appears like some of the written text in your
      posts are running off the screen. Can somebody else please comment and let me know if this is happening to them as well?
      This may be a issue with my browser because I’ve had this happen previously.
      Many thanks

    74. Lisette

      It is perfect time to make some plans for the future and it
      is time to be happy. I have read this post and if I could I
      wish to suggest you few interesting things or tips.
      Maybe you could write next articles referring to this article.
      I desire to read more things about it!

    78. Chanda

      I used to be recommended this web site through my cousin. I’m not certain whether or not this
      submit is written by means of him as no one else understand such certain about my
      difficulty. You’re incredible! Thanks!

    80. Dann

      My spouse and I absolutely love your blog and find the majority of
      your post’s to be just what I’m looking for. Does one offer guest writers to write content for yourself?
      I wouldn’t mind publishing a post or elaborating on some of the subjects you write
      regarding here. Again, awesome site!

    82. Dani

      Hmm it appears like your blog ate my first comment (it was
      super long) so I guess I’ll just sum it up what I had written and say, I’m thoroughly enjoying your blog.
      I too am an aspiring blog blogger but I’m still new to everything.
      Do you have any suggestions for first-time blog writers?
      I’d genuinely appreciate it.

    84. Shanna

      Hello are using WordPress for your blog platform? I’m new to the blog world but I’m trying
      to get started and create my own. Do you require any html coding knowledge to make your own blog?
      Any help would be greatly appreciated!

    86. Marge Allegretta

      Some really nice and utilitarian information on this site, likewise I think the style and design has good features.

    90. Melodee

      Hey would you mind stating which blog platform you’re working with?
      I’m looking to start my own blog in the near future but I’m having a hard time choosing between BlogEngine/Wordpress/B2evolution and Drupal.

      The reason I ask is because your design and style seems different then most blogs and I’m looking
      for something unique. P.S Sorry for being off-topic but I had to ask!

    91. https://jumpshare.com/v/aoAhBLiFUsgA6TCXT0lC

      Wonderful items from you, man. I’ve keep in mind your stuff prior to and you’re just too excellent.

      I actually like what you’ve acquired here, really like what
      you’re stating and the way during which you say it.
      You make it entertaining and you continue to take care
      of to stay it sensible. I can’t wait to learn far more from
      you. That is actually a great site.

    92. Stephaine

      I think everything published was very logical.
      But, what about this? what if you added a little content?

      I am not suggesting your content is not good., but what if
      you added something to maybe get a person’s attention? I mean Coluna
      vertebral: somos referência em tratamentos
      | ITC Vertebral Jundiaí is a little plain. You ought to peek at
      Yahoo’s front page and watch how they create news headlines to get people to click.
      You might add a related video or a pic or two to grab
      people interested about what you’ve written. Just
      my opinion, it might make your posts a little livelier.

    96. Leland

      Hello! I know this is somewhat off topic but I was wondering which blog platform are you using for this website?
      I’m getting tired of WordPress because I’ve had problems
      with hackers and I’m looking at alternatives for another platform.
      I would be great if you could point me in the direction of a good platform.

    97. Maxine

      Pretty nice post. I just stumbled upon your blog and wanted to
      say that I have really enjoyed surfing around your blog posts.
      In any case I’ll be subscribing to your rss feed and I hope you write again very soon!

    98. Genesis

      Right here is the right web site for everyone who wants to find out about this topic.
      You realize so much its almost hard to argue with you (not that I really will need
      to…HaHa). You certainly put a fresh spin on a subject
      that has been written about for a long time. Wonderful stuff, just excellent!

    99. Irving

      Do you have a spam problem on this blog; I also am a blogger, and I was wondering your situation; we
      have created some nice procedures and we are looking to swap methods with others, be
      sure to shoot me an e-mail if interested.

    101. Audra

      I’ll immediately clutch your rss feed as I can not find your e-mail subscription link or newsletter service.
      Do you have any? Please let me recognise in order that I may just subscribe.
      Thanks.

    104. Louie

      I’ll right away grasp your rss feed as I can’t find your e-mail subscription link or e-newsletter service.
      Do you’ve any? Please permit me know so that I may just subscribe.
      Thanks.

    105. Eli

      Hey! I know this is kinda off topic however I’d figured I’d ask.
      Would you be interested in trading links or maybe guest authoring a blog post or vice-versa?
      My website goes over a lot of the same subjects as yours
      and I feel we could greatly benefit from each other. If you might be
      interested feel free to send me an e-mail. I look forward to hearing from
      you! Fantastic blog by the way!

    106. Sherri

      Hi there this is kind of of off topic but I was wanting to know
      if blogs use WYSIWYG editors or if you have to manually
      code with HTML. I’m starting a blog soon but have no
      coding skills so I wanted to get advice from someone
      with experience. Any help would be enormously appreciated!

    107. Elvera

      I’m really enjoying the design and layout of your site.

      It’s a very easy on the eyes which makes it much more pleasant for me to come here and visit more often. Did you hire out a designer to create your
      theme? Great work!

    108. Isla

      Hello would you mind letting me know which hosting company you’re using?
      I’ve loaded your blog in 3 completely different browsers and I must say this blog
      loads a lot faster then most. Can you recommend a good internet hosting provider at a reasonable price?

      Many thanks, I appreciate it!

    112. Leonel Luebke

      I got what you intend, thankyou for putting up.Woh I am thankful to find this website through google. “You must pray that the way be long, full of adventures and experiences.” by Constantine Peter Cavafy.

    116. Christi Breach

      Thank you, I have recently been looking for information about this topic for a long time and yours is the best I’ve came upon till now. However, what in regards to the conclusion? Are you certain about the source?

    123. Anderson Jernejcic

      you’re really a just right webmaster. The web site loading speed is amazing. It seems that you’re doing any unique trick. Moreover, The contents are masterpiece. you have performed a wonderful task on this subject!

    124. Deshawn Raveling

      you’re really a excellent webmaster. The website loading pace is incredible. It kind of feels that you’re doing any distinctive trick. Moreover, The contents are masterpiece. you have performed a excellent process in this matter!

    125. Jaime Caballero

      Thank you, I’ve just been looking for information approximately this topic for a while and yours is the greatest I’ve found out so far. But, what about the bottom line? Are you positive about the supply?

    126. Andrea Pastrano

      You have noted very interesting details ! ps decent web site . “I’m going to a special place when I die, but I want to make sure my life is special while I’m here.” by Payne Stewart.

    128. Cleo Perce

      Hello my family member! I want to say that this post is awesome, nice written and include approximately all important infos. I’d like to see extra posts like this.

    182. Puppy coin whitepaper tokenomics

      Woah! I’m really loving the template/theme of
      this site. It’s simple, yet effective. A lot of times it’s very difficult to get that
      “perfect balance” between usability and visual appearance.
      I must say you have done a very good job with this.

      Additionally, the blog loads very quick for me on Chrome.
      Excellent Blog!

    185. VA Loan

      Hi there, I found your web site via Google at the same time as looking for a comparable topic, your website came up, it seems to be great.
      I’ve bookmarked it in my google bookmarks.

      Hello there, just become alert to your weblog through Google,
      and found that it’s really informative. I’m gonna be careful for brussels.

      I’ll be grateful if you happlen to proceed this in future.
      Many people can be benefited out of your writing.
      Cheers!

    186. kurumsal kimlik

      Whats uρ very cool web site!! Guy .. Beautifu .. Superb ..
      Ι will bookmark yourr site аnd take thhe feeds additionally?

      Ι am glad tоo seek ⲟut numerous usｅful informɑtion һere withіn tһe publish, we need develop more techniques іn thiks regard, thank you fοr sharing.
      . . . . .

      Feel free tо visit mmy site :: kurumsal kimlik

    204. Vape

      Hey! This is my 1st comment here so I just wanted to give a quick shout out and say I really
      enjoy reading through your articles. Can you recommend any
      other blogs/websites/forums that cover the same subjects?
      Thanks a ton!

    212. trtools.com.br

      Hi! I just wanted to ask if you ever have any issues with hackers?

      My last blog (wordpress) was hacked and I ended up losing months of hard work due to no back up.

      Do you have any solutions to protect against hackers?

    214. 층간소음매트

      Fantastic blog! Do you have any tips for aspiring writers?
      I’m planning to start my own website soon but I’m a little lost on everything.
      Would you suggest starting with a free platform like WordPress or go for a paid option? There
      are so many choices out there that I’m completely overwhelmed ..
      Any suggestions? Appreciate it!

    249. Check This Out

      Thethaobet games are among the more interesting and noted tendencies that have been happening in the last few years in the online casino industry.

      Live casino games were initially developed about
      10 decades ago as a niche type game primarily targeting
      the Asian markets, who voiced a requirement for such a kind of matches.
      At the time that has passed since then, dwell casino games have changed, developed and evolved quite a
      lot, making them as popular, exciting and rewarding in the Western world, especially in the united kingdom and Europe.Thethaobet casino games are actually online casino
      games where the player is actually engaging in a real live sport hosted either in a real casino or in a studio.
      The cards have been dealt with a real Thethaobet that has been especially trained to host
      such games and players can see exactly what is going
      on in the game and enjoy as far as possible
      the excitement and activity similar to what
      they’d encounter at a bricks and mortar casino.In the first days of the internet, lots of land based casino players, eager to test out
      the brand new medium of betting online, did not do this for two chief reasons.
      The first being that they did not feel comfortable with supplying their credit card details to some online thing they could
      not see or touch. The next was that players generally did not trust the random number generators (RNG), that would be the”motor” behind all online Thethaobet.
      A lot of people believed that the RNG was repaired and in the favor of the internet casino, thus creating
      the odds of you losing all of your money almost sure. At a land based casino, players can see the cards and the dealers and feel that the action on the casino floor.
      The simple fact that they were coping with actual live people
      made the entire business believable. Having a
      system deal the cards instead of a person was unthinkable in those days!

      This forced the online casino software suppliers to think of a solution; Thethaobet
      games in which the player could see the dealer and the action in the casino, just
      from the comfort of his own home while enjoying at an online casino.The first Thethaobet casino matches were
      fairly limited and didn’t really provide the player experience the online casino software companies hoped
      for, especially due to technological and technical reasons.
      Video streaming was very slow because of narrow the narrow band width which existed in those days and the effect on the players’ end was not the elegance and excitement on the real Vegas casino floors.
      For this reason, live casino games did not become as popular as the programmers and casino operators hoped for.
      Luckily, developments in video and bandwidth streaming have contributed largely to the capacity of software providers to
      improve and enhance live casino games closing the gap between the dream and vision to reality.Most online Thethaobet
      don’t develop their games in-house and buy a license from an organization which develops the software for
      online Thethaobet. The major software developers offering
      live casino games are Playtech, Microgaming and Evolution Gaming and they generally
      operate them to get their licensees, either from a TV studio
      or by a real land based casino. This usually means that you will probably see the exact same live casino
      games at online Thethaobet that are online. The reason for this is that the operating costs are higher than the conventional RNG powered games.
      The result is that this is the only business model so
      far that has shown itself rewarding to both the software
      developers and the online casino operators.
      Online Thethaobet generally offer a narrow selection of Thethaobet games, namely
      roulette, blackjack, baccarat, sic bo and casino grip’em.
      Roulette and blackjack are the most popular by far.When getting started using Thethaobet casino games you’re expected to choose the table and dealer you prefer.

      Traders are usually very good looking women; nevertheless
      there are also a few handsome men around to help keep the women returning for more.
      The live dealer manages the game, just like in a
      land based casino and they’re all exceptionally well
      trained and knowledgeable as they need to address many things in precisely the
      exact same moment. In case you have the sound on the computer
      turned on you are going to have the ability to hear all of the ongoings in the studio and even the Thethaobet wishing
      you luck.Almost all Thethaobet Thethaobet are controlled and are located
      in the UK, Ireland and Eastern Europe. The hands
      dealt to players are random and the sport is super fair just like at a land based casino and you are able to see everything with your eyes.Do you adore online Thethaobet?
      Are you someone who genuinely enjoys the amazing and unique degree of calmness
      and excitement that online Thethaobet offer you? Or have you just
      started out playing on online Thethaobet? In any event, you need to definitely continue reading
      to find some amazing, but less known truth about online Thethaobet.How would an wonderful casino sound?
      A casino is basically free money for you. This must sound quite amazing and
      it is just natural that you love receiving money at no cost.
      A casino is beyond any doubt something which all
      online casino gamers love, but as an experienced casino participant you should
      definitely learn more about it and as somebody just beginning, knowing
      all about what a casino is and how to receive your hands on one can unquestionably be a tremendous benefit for you.

    265. hey

      Howdy, I do believe your site could be having internet browser compatibility
      issues. Whenever I look at your website in Safari, it looks fine however when opening
      in IE, it has some overlapping issues. I just wanted
      to give you a quick heads up! Other than that, fantastic site!

    279. satta

      Someone essentially assist to make seriously
      articles I might state. This is the first time I frequented
      your web page and so far? I surprised with the analysis you made
      to make this particular put up amazing. Magnificent process!

    297. onesie pajamas

      Hola! I’ve been reading your weblog for a long time now and finally got the courage to go ahead and give you a
      shout out from Kingwood Texas! Just wanted to tell you keep up the great work!

    301. 1

      Do you have a spam issue on this blog; I also am a blogger, and
      I was curious about your situation; we have created some
      nice practices and we are looking to swap methods with others, please shoot me an e-mail if interested.

    316. instagram takipçi satın al

      Instagram adlı platform da arka planda kalmak istemiyorsanız bunun sebebi çevrenizdeki kişiler yada iş
      hayatınızda etkili olması için
      takipçi sayılarınızın fazla olması oldukça önemli bir konudur.

      Birden fazla instagram takipçi sitesi olmasına rağmen içlerinden en iyisi
      olanı çok araştırdık kelimesinin karşılığı olarak takipcintr.co olduğuna karar
      verdik
      ucuz ve hızlı teslimat ile gönüllerde taht kurmuşlar.

    318. instagram takipçi satın al

      It is perfect time to make some plans for the longer term and it’s time to be
      happy. I have read this publish and if I may
      just I desire to recommend you few attention-grabbing issues or advice.

      Maybe you can write subsequent articles referring to this article.
      I desire to learn even more issues about it!

    331. Cicely Kooyman

      Normally I do not learn article on blogs, but I would like to say that this write-up very compelled me to take a look at and do it! Your writing taste has been surprised me. Thanks, quite great post.

    401. hair falling out

      I’ve been surfing online more than 3 hours today, yet I never
      found any interesting article like yours. It’s pretty worth enough for me.
      Personally, if all site owners and bloggers made good content as
      you did, the internet will be much more useful than ever
      before.

      my site: hair falling out

    402. Harold Boner

      Hey, you used to write excellent, but the last few posts have been kinda boring… I miss your great writings. Past several posts are just a bit out of track! come on!

    439. Francina Payson

      Needed to send you the very little observation just to give many thanks yet again just for the extraordinary basics you have discussed on this site. This has been certainly pretty open-handed of people like you to provide unreservedly all a lot of folks could have sold for an e-book to help make some dough for themselves, especially given that you might have tried it if you wanted. These things likewise served to become good way to be aware that some people have the same eagerness just like mine to grasp way more concerning this matter. I am sure there are some more fun opportunities in the future for individuals who read through your blog.

    493. Spor Haberleri

      Merhaba, spor haberlerinden sende haberdar olmak için Sporun kralı olan, SporkraL.com dan faydalan,
      Son dakika spor haberleri, süperlig haberleri sizler için tek bir sitede
      hizmette.

    535. Kalıcı Takipçi

      I was curious if you ever considered changing the structure of
      your site? Its very well written; I love what youve got to say.
      But maybe you could a little more in the way of content so people
      could connect with it better. Youve got an awful lot of
      text for only having 1 or two pictures. Maybe you
      could space it out better?

    550. instagram takipçi almak

      My coder is trying to convince me to move to .net from
      PHP. I have always disliked the idea because of
      the costs. But he’s tryiong none the less. I’ve been using Movable-type on a variety of websites for about a year and am concerned about switching to
      another platform. I have heard excellent things about blogengine.net.
      Is there a way I can transfer all my wordpress content into it?
      Any kind of help would be really appreciated!

    559. xmovies8

      Its like you read my mind! You seem to know so much about this, like you wrote the
      book in it or something. I think that you can do with a few
      pics to drive the message home a bit, but other than that, this is magnificent blog.
      An excellent read. I will definitely be back.

    566. Tiktok izlenme satın al

      This design is spectacular! You most certainly know how to
      keep a reader amused. Between your wit and your videos, I was almost moved to start my own blog (well, almost…HaHa!) Wonderful job.

      I really enjoyed what you had to say, and more than that, how you presented it.
      Too cool!

    609. takipçi satın al

      What’s Taking place i’m new to this, I stumbled upon this I have discovered It positively
      helpful and it has aided me out loads. I hope
      to contribute & assist other users like its helped me.
      Good job.

    635. Life Experience Degree

      Hmm it looks like your site ate my first comment (it was extremely long) so I guess I’ll just sum it up what
      I wrote and say, I’m thoroughly enjoying your blog.
      I as well am an aspiring blog blogger but I’m still new to everything.
      Do you have any points for novice blog writers? I’d certainly appreciate it.

    679. judi slot online pulsa

      Whats up very nice site!! Guy .. Beautiful .. Wonderful ..
      I’ll bookmark your website and take the feeds also?
      I am satisfied to search out numerous helpful
      info here within the post, we need work out more
      strategies in this regard, thanks for sharing.
      . . . . .

    688. Pingback: order ivermectin online

    697. Judi slot online kaskus

      Its like you read my mind! You seem to know so much about this, like
      you wrote the book in it or something. I think that you can do with some pics to drive the message home
      a little bit, but other than that, this is great blog.
      A fantastic read. I’ll certainly be back.

    702. Pingback: ivermectin for sale

    706. Prediksi Togel Semua Pasaran

      Howdy! This blog post couldn’t be written much better!
      Reading through this article reminds me of my previous roommate!
      He always kept talking about this. I’ll send this post to him.
      Fairly certain he’ll have a good read. Thank you for sharing!