Medical & Biological Engineering & Computing

, Volume 48, Issue 2, pp 167–175 | Cite as

Theoretical evaluation of a simple cooling pad for inducing hypothermia in the spinal cord following traumatic injury

  • Katisha D. Smith
  • Liang ZhuEmail author
Original Article


The Pennes bioheat equation and finite element method (FEM) are used to solve for the temperature distributions in the spinal cord and cerebrospinal fluid (CSF) during 30 min of cooling for spinal cord injury (SCI) patients. The average CSF and spinal cord temperatures are reduced by 3.48 and 2.72°C, respectively. The 100-mm wide pad provides the desired cooling and uses the least amount of material. The presence of zero-average CSF oscillation under normal conditions decreases the cooling extent in the spinal cord due to the introduction of warm CSF surrounding the spinal cord. The temperature decrease in the spinal cord is more than doubled when the temperature at the back of the torso is lowered from 20 to 0°C. Spinal cord ischemia, often observed after traumatic spinal cord injury, promotes cooling penetration. The proposed technique can reduce the spinal cord temperature by 2°C within 30 min and may be a feasible treatment for traumatic SCI.


Spinal cord injury Cerebrospinal fluid Hypothermia Temperature Heat transfer 



This research was supported in part by the State of Maryland TEDCO fund, the LSAMP Bridge to the Doctorate Program, an NIGMS Initiative for Minority Student Development Grant (R25-GM55036), and Procter and Gamble. This research was performed by Katisha D. Smith in partial fulfillment of the requirements for the Ph.D. degree from the University of Maryland, Baltimore County.


  1. 1.
    Acosta-Rua G (1970) Treatment of traumatic paraplegic patients by localized cooling of the spinal cord. J Iowa Med Soc 60:326–328Google Scholar
  2. 2.
    Albin M, White R, Locke G (1965) Treatment of spinal cord trauma by selective hypothermic perfusion. Surg Forum 16:423–424Google Scholar
  3. 3.
    Albin M, White R, Yashon D et al (1968) Functional and electrophysiologic limitations of delayed spinal cord cooling after impact injury. Surg Forum 19:423–424Google Scholar
  4. 4.
    Albin M, White R, Acosta-Rua G et al (1968) Study of functional recovery produced by delayed localized cooling after spinal cord injury in primates. J Neurosurg 28:113–120Google Scholar
  5. 5.
    Balédent O, Henry–Feugeas M, Idy-Peretti I (2001) Cerebrospinal fluid dynamics and relation with blood flow: a magnetic resonance study with semiautomated cerebrospinal fluid segmentation. Invest Radiol 36:368–377CrossRefGoogle Scholar
  6. 6.
    Battin M, Penrice J, Gunn T et al (2003) Treatment of term infants with head cooling and mild systemic hypothermia (35.0°C and 34.5°C) after perinatal asphyxia. Pediatrics 111:244–251CrossRefGoogle Scholar
  7. 7.
    Black P, Van Devanter S, Cohn L (1976) Current research review: effects of hypothermia on systemic and organ system metabolism and function. J Surg Res 20:49–63CrossRefGoogle Scholar
  8. 8.
    Bricolo A, Ore G, Da Pian R et al (1976) Local cooling in spinal cord injury. Surg Neurol 6:101–106Google Scholar
  9. 9.
    Casas C, Herrera L, Prusmack C et al (2005) Effects of epidural hypothermic saline infusion on locomotor outcome and tissue preservation after moderate thoracic spinal cord contusion in rats. J Neurosurg-Spine 2:308–318CrossRefGoogle Scholar
  10. 10.
    Chandrupatla T, Belegundu A (2002) Introduction to finite elements in engineering. Prentice-Hall, Upper Saddle RiverGoogle Scholar
  11. 11.
    Diao C, Zhu L, Wang H (2003) Cooling and rewarming for brain ischemia or injury: Theoretical analysis. Ann Biomed Eng 31:346–353CrossRefGoogle Scholar
  12. 12.
    Dimar J, Shields C, Zhang Y et al (2000) The role of directly applied hypothermia in spinal cord injury. Spine 25:2294–2302CrossRefGoogle Scholar
  13. 13.
    Feinburg D, Mark A (1987) Human brain motion and cerebrospinal fluid circulation demonstrated with MR velocity imaging. Radiology 163:793–799Google Scholar
  14. 14.
    Goetz T, Romero-Sierra C, Ethier R et al (1988) Modeling of therapeutic dialysis of cerebrospinal fluid by epidural cooling in spinal cord injuries. J Neurotraum 5:139–150CrossRefGoogle Scholar
  15. 15.
    Gray H (2001) Gray’s anatomy: a facsimile. TAJ Books, LondonGoogle Scholar
  16. 16.
    Gül H (2007) Heat transfer in oscillating circular pipes. Exp Heat Transf 20:73–84CrossRefGoogle Scholar
  17. 17.
    Hansebout R, Kuchner E, Romero-Sierra C (1975) Effects of local hypothermia and of steroids upon recovery from experimental spinal cord compression injury. Surg Neurol 4:531–536Google Scholar
  18. 18.
    Hansebout R, Tanner A, Romero-Sierra C (1984) Current status of spinal cord cooling in the treatment of acute spinal cord injury. Spine 9:508–511CrossRefGoogle Scholar
  19. 19.
    Hansebout R, Lamont R, Kamath M (1985) The effects of local cooling on canine spinal cord blood flow. Can J Neurol Sci 12:83–87Google Scholar
  20. 20.
    Hausmann O (2003) Post-traumatic inflammation following spinal cord injury. Spinal Cord 41:369–378CrossRefGoogle Scholar
  21. 21.
    Hemida H, Sabry M, Abdel-Rahim A et al (2002) Theoretical analysis of heat transfer in laminar pulsating flow. Int J Heat Mass Transf 45:1767–1780zbMATHCrossRefGoogle Scholar
  22. 22.
    Hirsch C (1988) Numerical computation of internal and external flows. John Wiley & Sons, New YorkzbMATHGoogle Scholar
  23. 23.
    Huang P, Nian S, Yang C (2005) Enhanced heat-source cooling by flow pulsation and porous block. J Thermophys Heat Transf 19:460–470CrossRefGoogle Scholar
  24. 24.
    Hulsebosch C (2002) Recent advances in pathophysiology and treatment of spinal cord injury. Adv Physiol Educ 26:238–255Google Scholar
  25. 25.
    Inamasu J, Nakamura Y, Ichikizaki K (2003) Induced hypothermia in experimental traumatic spinal cord injury: an update. J Neurol Sci 209:55–60CrossRefGoogle Scholar
  26. 26.
    Incropera F, DeWitt D (1996) Fundamentals of heat and mass transfer, 4th edn. John Wiley and Sons, New YorkGoogle Scholar
  27. 27.
    Isaka M, Kumagai H, Sugawara Y et al (2006) Cold spinoplegia and transvertebral cooling pad reduce spinal cord injury during thoracoabdominal aortic surgery. J Vasc Surg 43:1257–1262CrossRefGoogle Scholar
  28. 28.
    Iwai H, Mambo T, Yamamoto N et al (2004) Laminar convective heat transfer from a circular cylinder exposed to a low frequency zero-mean velocity oscillating flow. Int J Heat Mass Transf 47:4659–4672CrossRefGoogle Scholar
  29. 29.
    Kwun B, Vacanti F (1995) Mild hypothermia protects against irreversible damage during prolonged spinal cord ischemia. J Surg Res 59:780–782CrossRefGoogle Scholar
  30. 30.
    Leong K, Jin L (2005) An experimental study of heat transfer in oscillating flow through a channel filled with aluminum foam. Int J Heat Mass Transf 48:243–253CrossRefGoogle Scholar
  31. 31.
    Li P, Yang K (2000) Mechanisms for the heat transfer enhancement in zero-mean oscillatory flows in short channels. Int J Heat Mass Transf 43:3551–3566zbMATHCrossRefGoogle Scholar
  32. 32.
    Loth F, Yardimci M, Alperin N (2001) Hydrodynamic modeling of cerebrospinal fluid motion within the spinal cavity. J Biomech Eng 123:71–79CrossRefGoogle Scholar
  33. 33.
    Maganæs B (1989) Clinical studies of cranial and spinal compliance and the craniospinal flow of cerebrospinal fluid. Br J Neurosurg 3:659–668CrossRefGoogle Scholar
  34. 34.
    Marsala M, Galik J, Ishikawa T et al (1997) Technique of selective spinal cord cooling in rat: methodology and application. J Neurosci Methods 74:97–106CrossRefGoogle Scholar
  35. 35.
    Martinez-Arizala A, Green B (1992) Hypothermia in spinal cord injury. J Neurotram 9:S497–S505Google Scholar
  36. 36.
    Minkowycz W, Sparrow E (1997) Advances in numerical heat transfer. Taylor & Francis, Washington DCGoogle Scholar
  37. 37.
    Mori A, Ueda T, Hachiya T et al (2005) An epidural cooling catheter protects the spinal cord against ischemia injury in pigs. Ann Thorac Surg 80:1829–1834CrossRefGoogle Scholar
  38. 38.
    O’Connell J (1943) Vascular factor in intracranial pressure and maintenance of cerebro-spinal fluid circulation. Brain 66:204–228CrossRefGoogle Scholar
  39. 39.
    Polderman K (2004) Application of therapeutic hypothermia in the ICU: opportunities and pitfalls of a promising treatment modality. Part 1: indications and evidence. Intensive Care Med 30:556–575CrossRefGoogle Scholar
  40. 40.
    Prytherch D, Smith M, Williams B (1979) The measurement of cerebrospinal fluid flow. Phys Med Biol 24:1196–1208CrossRefGoogle Scholar
  41. 41.
    Reyes O, Sosa I, Kuffler D (2003) Neuroprotection of spinal neurons against blunt trauma and ischemia. Puerto Rico Health Sci J 22:277–286Google Scholar
  42. 42.
    Rubini L, Colombo F (1981) Modified technique for local cooling in spinal cord injuries. Spine 6:417–419CrossRefGoogle Scholar
  43. 43.
    Saunders N, Habgood M, Dziegielewska K (1999) Barrier mechanisms in the brain. Clin Exp Pharmacol Physiol 26:11–19CrossRefGoogle Scholar
  44. 44.
    Schellinger D, LeBihan D, Rajan S et al (1992) MR of slow CSF flow in the spine. Am J Neuroradiol 13:1393–1403Google Scholar
  45. 45.
    Taoka Y, Okajima K (1998) Spinal cord injury in the rat. Prog Neurobiol 56:341–358CrossRefGoogle Scholar
  46. 46.
    Tator C (1972) Acute spinal cord injury: a review of recent studies of treatment and pathophysiology. Can Med Assoc J 107:143–150Google Scholar
  47. 47.
    Thienprasit P, Bantli H, Bloedel J et al (1975) Effect of delayed local cooling on experimental spinal cord injury. J Neurosurg 42:150–154CrossRefGoogle Scholar
  48. 48.
    Tsutsumi K, Ueda T, Shimizu H et al (2004) Effect of delayed induction of postischemic hypothermia on spinal cord damage induced by transient ischemic insult in rabbits. Jpn J Thorac Cardiovasc Surg 52:411–418CrossRefGoogle Scholar
  49. 49.
    Wang Y, Zhu L (2007) Targeted brain hypothermia induced by an interstitial cooling device in human neck: theoretical analyses. Eur J Appl Physiol 101:31–40CrossRefGoogle Scholar
  50. 50.
    Wang L, Yan Y, Zou L et al (2005) Moderate hypothermia prevents neural cell apoptosis following spinal cord ischemia in rabbits. Cell Res 15:387–393CrossRefGoogle Scholar
  51. 51.
    Wells J, Hansebout R (1978) Local hypothermia in experimental spinal cord trauma. Surg Neurol 10:200–204Google Scholar
  52. 52.
    Westergren H, Farooque M, Olsson Y et al (2001) Spinal cord blood flow changes following systemic hypothermia and spinal cord compression injury: an experimental study in the rat using Laser-Doppler flowmetry. Spinal Cord 39:74–84CrossRefGoogle Scholar
  53. 53.
    Xian H, Liu D, Shang F et al (2007) Study on heat transfer enhancement of oscillating-flow heat pipe for drying. Dry Technol 25:723–729CrossRefGoogle Scholar
  54. 54.
    Xu X, Tikuisis P, Giesbrecht G (1999) A mathematical model for human brain cooling during cold-water near-drowning. J Appl Physiol 86:265–272Google Scholar
  55. 55.
    Yashon D, Vise W, Dewey R et al (1973) Temperature of the spinal cord during local hypothermia in dogs. J Neurosurg 39:742–745CrossRefGoogle Scholar
  56. 56.
    Zhang X, Maruyama S, Sakai S (2004) Numerical investigation of laminar natural convection on a heated vertical plate subjected to a periodic oscillation. Int J Heat Mass Transf 47:4439–4448zbMATHCrossRefGoogle Scholar
  57. 57.
    Zhu L (2002) Chapter 2: bioheat transfer. In: Standard handbook of biomedical engineering and design. McGraw-Hill, New YorkGoogle Scholar
  58. 58.
    Zhu L, Diao C (2001) Theoretical simulation of temperature distribution in the brain during mild hypothermia treatment for brain injury. Med Biol Eng Comput 39:681–687CrossRefGoogle Scholar

Copyright information

© International Federation for Medical and Biological Engineering 2009

Authors and Affiliations

  1. 1.Department of Mechanical EngineeringUniversity of Maryland, Baltimore CountyBaltimoreUSA

Personalised recommendations