Methods and devices for cooling spinal tissue

Abstract

Methods, systems, and devices are disclosed for cooling tissue, and in particular for applying therapeutic hypothermia to the spinal canal, tissue disposed within the spinal canal, and nerve roots extending from the spinal canal. Bone screws, intervertebral implants, stabilization rods, spinous process spacers, and other devices are described which define a chamber through which a chilled fluid, expandable gas, or other coolant means can be circulated, delivered, or activated to cool adjacent tissue. The degree of cooling can be regulated using a controller, which can be configured to increase or decrease the cooling effect based on any of a variety of measured or predicted physiological or thermodynamic properties. Methods are disclosed for implanting cooling instruments and for carrying out various treatment regimens that involve cooling tissue using such instruments.

What is claimed is: 
     
         1 - 78 . (canceled) 
     
     
         79 . A spinous process cooling instrument, comprising:
 an implant sized and configured for placement between a first spinous process of a first vertebra and a second spinous process of a second vertebra such that the implant stabilizes the first and second vertebrae, the implant having a chamber defined therein;   a delivery conduit coupled to the implant and in fluid communication with the chamber, the delivery conduit being configured to supply a cooling medium to the chamber; and   an exhaust conduit coupled to the implant and in fluid communication with the chamber.   
     
     
         80 . The instrument of  claim 79 , wherein the implant is sized and configured for placement between first and second adjacent vertebrae. 
     
     
         81 . The instrument of  claim 79 , wherein the chamber is located within a portion of the implant that is configured to be placed between the first and second spinous processes. 
     
     
         82 . The instrument of  claim 79 , wherein the chamber is disposed adjacent to an anterior surface of the implant. 
     
     
         83 . The instrument of  claim 79 , wherein the chamber comprises a looped fluid lumen that extends between the delivery conduit and the exhaust conduit. 
     
     
         84 . The instrument of  claim 79 , wherein the implant comprises a superior wing portion configured for placement against a spinous process of a superior vertebra, an inferior wing portion configured for placement against a spinous process of an inferior vertebra, and a central portion disposed between the superior and inferior wing portions. 
     
     
         85 . The instrument of  claim 79 , wherein the delivery conduit and the exhaust conduit are coupled to a posterior surface of the implant. 
     
     
         86 . A spinous process cooling instrument, comprising:
 an implant sized and configured for placement against a first spinous process of a first vertebra and a second spinous process of a second vertebra, the implant having a chamber defined therein;   a delivery conduit coupled to the implant and in fluid communication with the chamber, the delivery conduit being configured to supply a cooling medium to the chamber; and   an exhaust conduit coupled to the implant and in fluid communication with the chamber.   
     
     
         87 . The instrument of  claim 86 , wherein the implant is sized and configured for placement against first and second adjacent vertebrae. 
     
     
         88 . The instrument of  claim 86 , wherein the chamber is located within a portion of the implant that is configured to be placed intermediate of the first and second spinous processes. 
     
     
         89 . The instrument of  claim 86 , wherein the chamber is disposed adjacent to an anterior surface of the implant. 
     
     
         90 . The instrument of  claim 86 , wherein the chamber comprises a looped fluid lumen that extends between the delivery conduit and the exhaust conduit. 
     
     
         91 . The instrument of  claim 86 , wherein the implant comprises a superior wing portion configured for placement against a spinous process of a superior vertebra, an inferior wing portion configured for placement against a spinous process of an inferior vertebra, and a central portion disposed between the superior and inferior wing portions. 
     
     
         92 . The instrument of  claim 86 , wherein the delivery conduit and the exhaust conduit are coupled to a posterior surface of the implant. 
     
     
         93 . A method of cooling tissue, comprising:
 forming a tissue opening to access a spinal column of a patient;   passing an implant through the tissue opening;   positioning the implant in contact with a first spinous process of a first vertebra of the patient; and   applying a cooling effect from the implant to cool tissue in a spinal canal of the patient.   
     
     
         94 . The method of  claim 93 , wherein positioning the implant comprises positioning the implant between the first spinous process and a second spinous process of a second vertebra of the patient. 
     
     
         95 . The method of  claim 94 , wherein the first and second vertebrae are adjacent. 
     
     
         96 . The method of  claim 94 , further comprising attaching the implant to at least one of the first and second spinous processes. 
     
     
         97 . The method of  claim 94 , wherein positioning the implant comprises positioning a superior wing portion of the implant against the first spinous process, positioning an inferior wing portion of the implant against the second spinous process, and positioning a central portion of the implant between the first and second spinous processes. 
     
     
         98 . The method of  claim 93 , wherein applying the cooling effect comprises applying the cooling effect through the first spinous process to the tissue in the spinal canal. 
     
     
         99 . The method of  claim 93 , further comprising closing the tissue opening such that delivery and exhaust conduits coupled to the implant extend through the tissue opening. 
     
     
         100 . The method of  claim 99 , further comprising detaching the delivery and exhaust conduits from the implant and removing the delivery and exhaust conduits through the tissue opening. 
     
     
         101 . The method of  claim 93 , wherein applying the cooling effect includes applying the cooling effect after the tissue opening is closed.