With realistic water flows, a pure copper waterblock that fits within AMD's space guidelines, and the XP processor you could get down in the 0.09 C/W range. To get below that, you would need to use some type of heat pipe base or a material with a higher thermal conductivity than copper ( say, pyrolitic graphite

).
"Regular" heat spreaders on processors do
not improve matters, in fact they make things worse, by virtue of the fact that they
add another heat transfer boundary. The "good" of a heat spreader is that it tends to be a bit more forgiving in the case of incorrectly mounted blocks and helps to protect the core from damage. There is nothing "magical" about them, they are just copper and thermal paste.