Implantable devices for thermal therapy and related methods
Methods and devices are disclosed herein that generally involve applying thermal therapy to tissue (e.g., localized cooling or heating of tissue), and in particular applying thermal therapy to the spinal canal, tissue disposed within the spinal canal, and/or nerve roots extending from the spinal canal. In some embodiments, tissue can be cooled or heated by implanting a malleable or deformable thermal device in proximity to the targeted tissue. The thermal device can be left in place following surgery to facilitate application of post-surgical thermal therapy. In some embodiments, the thermal device can be removed post-surgery in a minimally- or non-invasive manner. The thermal device can be connectionless or can include penetrable regions, pre-attached tubing, or detachable connectors to facilitate application of cooling or heating means to the device. Methods are disclosed for utilizing thermal devices and for carrying out various treatment regimens that involve cooling or heating tissue using such devices.
1. A method of applying thermal therapy to tissue, the method comprising:
forming a tissue opening in a patient to access a target site within the patient, wherein the target site is spinal cord dura mater;
performing a laminectomy to expose a posterior surface of the spinal cord dura mater;
passing a thermal device comprising a malleable or deformable pad formed of a membrane defining an internal fluid reservoir through the tissue opening; and
placing the thermal device at the target site wherein the internal fluid reservoir is in thermal contact with the target site and applying thermal therapy to the target site by placing an outer surface of the thermal device onto the target site.
2. The method of claim 1 , wherein the malleable or deformable pad is resiliently or non-resiliently malleable or deformable.
3. The method of claim 1 , wherein the membrane is configured to form a negative of an anatomical feature against which it is placed.
4. The method of claim 1 , wherein the malleable or deformable pad is formed from one or more of the following: silicone, polyethylene terephthalate (PET), nylon, polyethylene (PE), polyurethane, polyvinyl chloride (PVC), latex, titanium, steel, gold, cobalt, chrome, or combinations thereof.
5. The method of claim 1 , wherein the malleable or deformable pad includes wings or tabs which define a thermal transfer surface and a malleable wireframe disposed therein.
6. The method of claim 5 , wherein the wireframe may be shaped to contour the spinal cord dura mater.
7. The method of claim 1 , wherein thermal therapy is applied to the target site through the thermal device before the tissue opening is closed.
8. The method of claim 1 , further comprising:
closing the tissue opening with the thermal device at the target site; and
after closing the tissue opening, applying or continuing to apply thermal therapy to the target site via the thermal device.
9. The method of claim 8 , further comprising installing one or more spinal fixation implants prior to closing the tissue opening.
10. The method of claim 1 , wherein the thermal device is placed on the exposed posterior surface of the spinal cord dura mater.
11. The method of claim 1 , wherein the thermal device comprises an insulating coating positioned on all portions of the thermal device except for a thermal transfer surface that is placed on the target site.
12. The method of claim 11 , wherein the insulating coating is silicone.
13. The method of claim 1 , wherein the internal fluid reservoir contains one or more embedded sensors.
14. The method of claim 13 , wherein a temperature sensor is one of the one or more embedded sensors.
15. The method of claim 1 , further comprising removing the thermal device after completion of the thermal therapy.
16. The method of claim 1 , wherein the internal fluid reservoir includes a thermal transfer fluid selected from the group consisting of: saline solution, water, liquid nitrogen, ethyl alcohol, and combinations thereof.
17. The method of claim 1 , wherein the malleable or deformable pad includes an embedded malleable wireframe disposed therein that may be shaped to contour the spinal cord dura mater.