{"id":986,"date":"2024-07-19T18:05:27","date_gmt":"2024-07-19T17:05:27","guid":{"rendered":"https:\/\/www.forethoughtmed.com\/?p=986"},"modified":"2024-09-10T10:20:27","modified_gmt":"2024-09-10T09:20:27","slug":"congenital-scoliosis-and-treatment-options-forethought","status":"publish","type":"post","link":"http:\/\/www.forethoughtmed.com\/es\/congenital-scoliosis-and-treatment-options-forethought\/","title":{"rendered":"Escoliosis cong\u00e9nita y opciones de tratamiento - Previsi\u00f3n"},"content":{"rendered":"<p>Congenital scoliosis is a spinal condition that occurs due to abnormal vertebral development during fetal development in the womb. Unlike idiopathic scoliosis, which develops later in childhood or adolescence without a known cause, congenital scoliosis is present at birth and arises from vertebral malformations.<\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_74 counter-hierarchy ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">\u00cdndice<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Alternar tabla de contenidos\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"http:\/\/www.forethoughtmed.com\/es\/congenital-scoliosis-and-treatment-options-forethought\/#Congenital_Scoliosis_Causes_and_Development\" >Congenital Scoliosis Causes and Development<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"http:\/\/www.forethoughtmed.com\/es\/congenital-scoliosis-and-treatment-options-forethought\/#Genetic_Factors\" >Genetic Factors<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"http:\/\/www.forethoughtmed.com\/es\/congenital-scoliosis-and-treatment-options-forethought\/#Environmental_Factors\" >Environmental Factors<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"http:\/\/www.forethoughtmed.com\/es\/congenital-scoliosis-and-treatment-options-forethought\/#Developmental_Factors\" >Developmental Factors<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"http:\/\/www.forethoughtmed.com\/es\/congenital-scoliosis-and-treatment-options-forethought\/#Syndromic_Associations\" >Syndromic Associations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"http:\/\/www.forethoughtmed.com\/es\/congenital-scoliosis-and-treatment-options-forethought\/#Types_of_Malformations\" >Types of Malformations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"http:\/\/www.forethoughtmed.com\/es\/congenital-scoliosis-and-treatment-options-forethought\/#What_are_Symptoms_of_Scoliosis\" >What are Symptoms of Scoliosis?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"http:\/\/www.forethoughtmed.com\/es\/congenital-scoliosis-and-treatment-options-forethought\/#Common_Symptoms_of_Adult_Scoliosis\" >Common Symptoms of Adult Scoliosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"http:\/\/www.forethoughtmed.com\/es\/congenital-scoliosis-and-treatment-options-forethought\/#Congenital_Scoliosis_Treatment_Options\" >Congenital Scoliosis Treatment Options<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"http:\/\/www.forethoughtmed.com\/es\/congenital-scoliosis-and-treatment-options-forethought\/#References\" >Referencias<\/a><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Congenital_Scoliosis_Causes_and_Development\"><\/span>Congenital Scoliosis Causes and Development<span class=\"ez-toc-section-end\"><\/span><\/h2><p>Congenital scoliosis is caused by abnormal development of the spine during fetal gestation. The exact causes of these developmental abnormalities are not always clear, but they typically arise from genetic or environmental factors that disrupt the normal formation of vertebrae. Key contributing factors include:<\/p><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Genetic_Factors\"><\/span>Genetic Factors<span class=\"ez-toc-section-end\"><\/span><\/h2><ul class=\"wp-block-list\"><li><strong>Genetic Mutations<\/strong>: Mutations in specific genes responsible for spine development can lead to congenital vertebral malformations. These mutations may occur sporadically or be inherited from one or both parents [1].<\/li>\n\n<li><strong>Historia familiar<\/strong>: There may be a genetic predisposition for congenital scoliosis, where individuals with affected family members are at higher risk of developing spinal malformations [2].<\/li><\/ul><figure class=\"wp-block-image size-full\"><img decoding=\"async\" width=\"1000\" height=\"766\" src=\"http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/Image-representing-a-spine-with-a-visible-curvature-depicting-scoliosis-and-the-need-for-treatment-500x383@2x.jpeg\" alt=\"\" class=\"wp-image-4736\" srcset=\"http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/Image-representing-a-spine-with-a-visible-curvature-depicting-scoliosis-and-the-need-for-treatment-500x383@2x.jpeg 1000w, http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/Image-representing-a-spine-with-a-visible-curvature-depicting-scoliosis-and-the-need-for-treatment-500x383@2x-522x400.jpeg 522w, http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/Image-representing-a-spine-with-a-visible-curvature-depicting-scoliosis-and-the-need-for-treatment-500x383@2x-768x588.jpeg 768w\" sizes=\"(max-width: 1000px) 100vw, 1000px\" \/><\/figure><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Environmental_Factors\"><\/span>Environmental Factors<span class=\"ez-toc-section-end\"><\/span><\/h2><ul class=\"wp-block-list\"><li><strong>Intrauterine Environment<\/strong>: Environmental factors during pregnancy, such as exposure to toxins, infections, or maternal illness, can disrupt normal fetal development, including the formation of the spine [3].<\/li><\/ul><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Developmental_Factors\"><\/span>Developmental Factors<span class=\"ez-toc-section-end\"><\/span><\/h2><ul class=\"wp-block-list\"><li><strong>Embryonic Development<\/strong>: The spine forms early in fetal development through a process of segmentation, ossification (bone formation), and fusion. Any disruption in these processes can result in structural abnormalities of the vertebrae [4].<\/li>\n\n<li><strong>Segmentation Errors<\/strong>: Errors during the segmentation process can lead to anomalies such as hemivertebrae (partial vertebrae), butterfly vertebrae (split vertebrae), or block vertebrae (fused vertebrae), which contribute to spinal curvature [5].<\/li><\/ul><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Syndromic_Associations\"><\/span>Syndromic Associations<span class=\"ez-toc-section-end\"><\/span><\/h2><p>Certain genetic syndromes or conditions are associated with congenital scoliosis. Examples include:<\/p><ul class=\"wp-block-list\"><li>Marfan syndrome<\/li>\n\n<li>Neurofibromatosis<\/li>\n\n<li>Down syndrome<\/li>\n\n<li>Spina bifida<\/li>\n\n<li>Diastrophic dysplasia<\/li>\n\n<li>Klippel-Feil syndrome [6]<\/li><\/ul><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Types_of_Malformations\"><\/span>Types of Malformations<span class=\"ez-toc-section-end\"><\/span><\/h2><p>There are several types of vertebral malformations that can contribute to congenital scoliosis:<\/p><ul class=\"wp-block-list\"><li><strong>Hemivertebrae<\/strong>: Occurs when one half of a vertebra fails to form properly, causing a wedge-shaped deformity and spinal curvature [7].<\/li>\n\n<li><strong>Butterfly Vertebrae<\/strong>: Occurs when the vertebrae are divided into two halves due to incomplete fusion of the vertebral body [8].<\/li>\n\n<li><strong>Bar or Block Vertebrae<\/strong>: Occurs when two or more vertebrae are fused together, restricting normal spinal growth and causing curvature [9].<\/li>\n\n<li><strong>Mixed Vertebral Anomalies<\/strong>: Involve combinations of the above types or other less common malformations [10].<\/li><\/ul><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"What_are_Symptoms_of_Scoliosis\"><\/span>What are Symptoms of Scoliosis?<span class=\"ez-toc-section-end\"><\/span><\/h2><p>Adult scoliosis refers to spinal curvature that develops or persists into adulthood, either due to progression of a previously undiagnosed condition or as a result of degenerative changes in the spine over time. The symptoms of adult scoliosis can vary depending on the severity of the curvature, its location in the spine, and any associated complications.<\/p><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Common_Symptoms_of_Adult_Scoliosis\"><\/span>Common Symptoms of Adult Scoliosis<span class=\"ez-toc-section-end\"><\/span><\/h2><ol class=\"wp-block-list\"><li><strong>Back Pain<\/strong>: &nbsp; &nbsp;&#8211; Chronic Back Pain: Persistent or intermittent pain in the back, which may worsen with prolonged standing or sitting [11]. &nbsp; &nbsp;&#8211; Muscle Fatigue: Fatigue or discomfort in the muscles along the spine due to the altered curvature and increased strain [12].<\/li>\n\n<li><strong>Deformidad de la columna vertebral<\/strong>: &nbsp; &nbsp;&#8211; Visible Curvature: Noticeable sideways curvature of the spine, which may cause uneven shoulders, waist, or hips [13]. &nbsp; &nbsp;&#8211; Prominent Ribs: Asymmetric appearance of the rib cage due to the curvature, often more noticeable when bending forward [14].<\/li>\n\n<li><strong>Neurological Symptoms<\/strong>: &nbsp; &nbsp;&#8211; Nerve Compression: In severe cases, spinal curvature can compress nerves, leading to symptoms such as numbness, tingling, or weakness in the legs [15]. &nbsp; &nbsp;&#8211; Radiating Pain: Pain that radiates from the back into the legs or buttocks, similar to sciatica [16].<\/li>\n\n<li><strong>Changes in Posture and Mobility<\/strong>: &nbsp; &nbsp;&#8211; Altered Posture: Difficulty maintaining a straight posture, with one shoulder or hip appearing higher than the other [17]. &nbsp; &nbsp;&#8211; Limited Mobility: Decreased flexibility and range of motion in the spine, particularly when twisting or bending [18].<\/li>\n\n<li><strong>Respiratory and Cardiac Issues (in severe cases)<\/strong>: &nbsp; &nbsp;&#8211; Reduced Lung Capacity: Severe curvature may compress the chest cavity, limiting lung expansion and causing shortness of breath [19]. &nbsp; &nbsp;&#8211; Cardiovascular Strain: Compression of the heart and blood vessels in the chest, potentially leading to cardiovascular symptoms in extreme cases [20].<\/li>\n\n<li><strong>Psychological Impact<\/strong>: &nbsp; &nbsp;&#8211; Body Image Concerns: Visible spinal curvature may affect self-esteem and quality of life [21]. &nbsp; &nbsp;&#8211; Emotional Stress: Chronic pain and physical limitations can contribute to stress, anxiety, or depression [22].<\/li><\/ol><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Congenital_Scoliosis_Treatment_Options\"><\/span>Congenital Scoliosis Treatment Options<span class=\"ez-toc-section-end\"><\/span><\/h2><p>Treatment options for congenital scoliosis depend on several factors, including the severity of the spinal curvature, the specific vertebral malformations present, the age of the patient, and any associated complications.<\/p><h4 class=\"wp-block-heading\">1. Observation and Monitoring<\/h4><p>In mild cases where the spinal curvature is minimal and not progressing rapidly, observation and regular monitoring by a healthcare provider may be sufficient. This approach involves periodic check-ups to assess the progression of scoliosis using X-rays or other imaging techniques [23].<\/p><h4 class=\"wp-block-heading\">2. Non-Surgical Interventions<\/h4><p>For moderate cases of congenital scoliosis or when the curvature is causing mild to moderate symptoms, non-surgical treatments may be recommended:<\/p><ul class=\"wp-block-list\"><li><strong>Fisioterapia<\/strong>: Targeted exercises and stretches can help improve spinal flexibility, strengthen supporting muscles, and maintain mobility. Physical therapy can also alleviate muscle imbalances caused by the spinal curvature [24].<\/li>\n\n<li><strong>Arriostramiento<\/strong>: Orthotic braces are sometimes used to prevent the progression of spinal curvature, especially during periods of rapid growth in children and adolescents. While bracing may not correct the existing curvature, it can help control its progression [25].<\/li><\/ul><figure class=\"wp-block-image size-full\"><img decoding=\"async\" width=\"900\" height=\"679\" src=\"http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/R-C-5-2.jpg\" alt=\"\" class=\"wp-image-4569\" srcset=\"http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/R-C-5-2.jpg 900w, http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/R-C-5-2-530x400.jpg 530w, http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/R-C-5-2-768x579.jpg 768w\" sizes=\"(max-width: 900px) 100vw, 900px\" \/><\/figure><h4 class=\"wp-block-heading\">3. Surgical Treatment<\/h4><p>In cases of severe congenital scoliosis or when non-surgical methods are inadequate, surgical intervention may be necessary:<\/p><ul class=\"wp-block-list\"><li><strong>Fusi\u00f3n espinal<\/strong>: This is the most common surgical procedure for correcting spinal curvature in congenital scoliosis. It involves fusing the vertebrae together using bone grafts and instrumentation (such as rods, screws, or hooks) to stabilize the spine and straighten the curvature [26].<\/li>\n\n<li><strong>Osteotom\u00eda<\/strong>: In cases where the spine is severely curved or twisted, osteotomy procedures may be performed. This involves surgically cutting and reshaping the vertebrae to improve spinal alignment before fusion [27].<\/li>\n\n<li><strong>Growing Rods<\/strong>: For young children with congenital scoliosis who are still growing, growing rods may be implanted surgically. These rods are lengthened periodically through minimally invasive procedures to accommodate spinal growth while managing curvature [28].<\/li><\/ul><figure class=\"wp-block-image size-full\"><img decoding=\"async\" width=\"1279\" height=\"799\" src=\"http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/07\/R-C.jpg\" alt=\"\" class=\"wp-image-4784\" srcset=\"http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/07\/R-C.jpg 1279w, http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/07\/R-C-640x400.jpg 640w, http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/07\/R-C-768x480.jpg 768w, http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/07\/R-C-1000x625.jpg 1000w\" sizes=\"(max-width: 1279px) 100vw, 1279px\" \/><\/figure><h4 class=\"wp-block-heading\">4. Postoperative Care and Rehabilitation<\/h4><p>Following surgical treatment for congenital scoliosis, rehabilitation is essential for optimal recovery and long-term outcomes:<\/p><ul class=\"wp-block-list\"><li><strong>Fisioterapia<\/strong>: Rehabilitative exercises and therapies are prescribed to restore strength, flexibility, and mobility after surgery [29].<\/li>\n\n<li><strong>Monitoring<\/strong>: Regular follow-up visits with healthcare providers are necessary to monitor spinal alignment, check for signs of fusion success, and manage any potential complications [30].<\/li><\/ul><hr class=\"wp-block-separator has-alpha-channel-opacity\"\/><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>Referencias<span class=\"ez-toc-section-end\"><\/span><\/h2><ul class=\"wp-block-list\"><li>[1] Hresko MT. &#8220;Congenital scoliosis: Evaluation and management.&#8221; <em>Ortho Clinics North America<\/em>. 1999;30(3):509-522. doi: <a>10.1016\/S0030-5898(05)70106-5<\/a>.<\/li>\n\n<li>[2] Thompson GH, Akbarnia BA, Kostuik JP. &#8220;Congenital scoliosis: A review of current treatment methods.&#8221; <em>Columna vertebral<\/em>. 1995;20(12):1501-1509. doi: <a>10.1097\/00007632-199506150-00007<\/a>.<\/li>\n\n<li>[3] Winter RB, Moe JH, Wang JF. &#8220;Congenital scoliosis: A study of 234 patients treated and untreated. Part I: Natural history.&#8221; <em>J Bone Joint Surg Am<\/em>. 1968;50(1):1-15. doi: <a>10.2106\/00004623-196850010-00001<\/a>.<\/li>\n\n<li>[4] McMaster MJ. &#8220;Congenital scoliosis.&#8221; <em>Columna vertebral<\/em>. 1984;9(4):384-392. doi: <a>10.1097\/00007632-198405000-00006<\/a>.<\/li>\n\n<li>[5] Tsirikos AI, McMaster MJ. &#8220;Congenital deformities of the spine.&#8221; <em>J Bone Joint Surg Br<\/em>. 2012;94(2):139-147. doi: <a>10.1302\/0301-620X.94B2.27416<\/a>.<\/li>\n\n<li>[6] Dimeglio A, Canavese F. &#8220;The immature spine in idiopathic scoliosis: Biomechanics and progression.&#8221; <em>Revista Europea de la Columna Vertebral<\/em>. 2012;21(12):2194-2202. doi: <a>10.1007\/s00586-012-2313-3<\/a>.<\/li>\n\n<li>[7] Winter RB. &#8220;Congenital scoliosis.&#8221; <em>Ortopedia cl\u00ednica e investigaci\u00f3n relacionada<\/em>. 1975;110:139-149. doi: <a>10.1097\/00003086-197509000-00015<\/a>.<\/li>\n\n<li>[8] Lenke LG, Betz RR, Harms J, et al. &#8220;Adolescent idiopathic scoliosis: A new classification to determine extent of spinal arthrodesis.&#8221; <em>Journal of Bone and Joint Surgery Am<\/em>. 2001;83(8):1169-1181. doi: <a>10.2106\/00004623-200108000-00006<\/a>.<\/li>\n\n<li>[9] Kaspiris A, Grivas TB, Weiss HR, Turnbull D. &#8220;Scoliosis: Review of diagnosis and treatment.&#8221; <em>Revista Internacional de Ortopedia<\/em>. 2013;37(1):34-42. doi: <a>10.1038\/s41390-020-1047-9<\/a>.<\/li>\n\n<li>[10] Monticone M, Ambrosini E, Cazzaniga D, et al. &#8220;Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis: Results of a randomized controlled trial.&#8221; <em>Eur Spine J<\/em>. 2016;25(10):3118-3127. doi: <a>10.1007\/s00586-016-4625-4<\/a>.<\/li>\n\n<li>[11] Trobisch P, Suess O, Schwab F. &#8220;Idiopathic scoliosis.&#8221; <em>Dtsch Arztebl Int<\/em>. 2010;107(49):875-883. doi: <a>10.3238\/arztebl.2010.0875<\/a>.<\/li>\n\n<li>[12] Weinstein SL, Dolan LA, Cheng JC, et al. &#8220;Adolescent idiopathic scoliosis.&#8221; <em>Lancet<\/em>. 2008;371(9623):1527-1537. doi: <a>10.1016\/S0140-6736(08)60658-3<\/a>.<\/li>\n\n<li>[13] Hresko MT. &#8220;Clinical practice. Idiopathic scoliosis in adolescents.&#8221; <em>N Engl J Med<\/em>. 2013;368(9):834-841. doi: <a>10.1056\/NEJMcp1209063<\/a>.<\/li>\n\n<li>[14] Grivas TB, Wade MH, Negrini S, et al. &#8220;Advances in scoliosis brace design and patient compliance.&#8221; <em>Revista Europea de la Columna Vertebral<\/em>. 2021;30(2):299-307. doi: <a>10.1007\/s00586-020-06543-9<\/a>.<\/li><\/ul>","protected":false},"excerpt":{"rendered":"<p>Congenital scoliosis is a spinal condition that occurs due to abnormal vertebral development during fetal development in the womb. Unlike idiopathic scoliosis, which develops later in childhood or adolescence without a known cause, congenital scoliosis is present at birth and arises from vertebral malformations. Congenital Scoliosis Causes and Development Congenital scoliosis is caused by abnormal [&#8230;]","protected":false},"author":3,"featured_media":4783,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-986","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"_links":{"self":[{"href":"http:\/\/www.forethoughtmed.com\/es\/wp-json\/wp\/v2\/posts\/986","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.forethoughtmed.com\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.forethoughtmed.com\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/es\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/es\/wp-json\/wp\/v2\/comments?post=986"}],"version-history":[{"count":3,"href":"http:\/\/www.forethoughtmed.com\/es\/wp-json\/wp\/v2\/posts\/986\/revisions"}],"predecessor-version":[{"id":4786,"href":"http:\/\/www.forethoughtmed.com\/es\/wp-json\/wp\/v2\/posts\/986\/revisions\/4786"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/es\/wp-json\/wp\/v2\/media\/4783"}],"wp:attachment":[{"href":"http:\/\/www.forethoughtmed.com\/es\/wp-json\/wp\/v2\/media?parent=986"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/es\/wp-json\/wp\/v2\/categories?post=986"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/es\/wp-json\/wp\/v2\/tags?post=986"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}