Bone Marrow Biopsy Procedure

At the center of the large bones in your body are large amounts of a spongy substance known as bone marrow. After birth, this tissue synthesizes all the different cells that form the blood; while in the womb, this process is shared with the spleen and liver. They make red blood cells that are needed for transporting oxygen from the lungs to the body tissues, white blood cells that are involved in the immune response to combat infections, and platelets that allow the blood to clot when you are injured. Sometimes, when there is something wrong with these cells, the bone marrow biopsy procedure (medically known as bone marrow aspiration and biopsy) will be needed.

When Is a Bone Marrow Biopsy Procedure Needed?

If the levels of red blood cells, white blood cells, or platelets are low, a bone marrow biopsy, which involves taking a sample of the solid bone and the liquid part of the marrow with an aspiration, may be needed. Unhealthy bone marrow may be due to one of several conditions. To assess the underlying cause, your doctor may order a blood test. This can detect for the presence of any suspected bone condition, assess disease progression, and see how effective any treatment has been. If you are currently undergoing cancer treatment, a bone marrow biopsy can determine whether the cancer has spread to the bones.

Common diseases affecting the bone marrow include:

  • Anemia or reduced red blood cell levels
  • Certain infections, e.g., sepsis
  • Conditions affecting the blood cells, e.g., polycythemia and leukopenia
  • Bone-marrow specific diseases, e.g., myelodysplastic syndrome and myelofibrosis
  • Blood and bone marrow cancers, e.g., lymphoma and leukemia
  • The genetic disorder hemochromatosis, which leads to the accumulation of iron in the blood

Before Bone Marrow Biopsy

Prior to undergoing a bone marrow biopsy procedure, you need speak to your doctor about any allergies you have, and any prescription, over-the-counter medications, or home remedies you are taking. It's also important to tell your physician if you have had any bleeding issues or any adverse reactions to drugs, and if you are pregnant.

Patients undergoing bone marrow biopsy are often advised to refrain from eating or drinking prior to the operation. Before the procedure, you need change into a hospital gown, and then the doctor will measure your basic signs: blood pressure, breathing rate, heart rate, and body temperature. He or she may also take a sample of your blood and/or give you some sedatives. Depending on the side of your body the biopsy will be taken from, you will be asked to lie on your stomach or on your side.

During Bone Marrow Biopsy

You can receive the bone marrow biopsy as part of a hospital stay or on an outpatient basis. Depending on the healthcare setting and your underlying health condition, the bone marrow biopsy procedure may vary somewhat. For instance, the iliac crest of the pelvis is the most common site for bone marrow biopsy, but your surgeon may choose another site, such as the breastbone. Vertebrae and leg bones are often selected for child patients. However, here is a general overview of bone marrow biopsy procedure.

  1. You will be asked to keep still as much as possible.
  2. The doctor will clean the overlying skin region with antiseptic fluid.
  3. You'll feel a needle pick and slight sting as your physician administers the local anesthetic to numb the area.
  4. The surgeon will perform a small cut over the biopsy region and insert a biopsy needle through the bone to reach the marrow.
  5. The first part of the biopsy involves taking an aspiration of the bone marrow as a liquid sample. You will usually sense an increase in pressure as the needle is pushed into the bone and a pulling feeling as the needle is taken out.
  6. The next stage is to use a specialized hollow needle to perform what's known as a core biopsy – sampling a small, solid portion of the marrow.
  7. This needle is then removed, and pressure will need to be applied to the biopsy region for several minutes to stop any bleeding.
  8. Sterile bandages/dressings are then applied to the area.
  9. For diagnosis, the sample is then sent for laboratory testing.

The video below shows one person's experience of this procedure, you will get direct understanding from it:

After Bone Marrow Biopsy

For around a week after the bone marrow biopsy procedure, you may feel some slight pain, which can be easily treated with over-the-counter medicines. To take good care of the wound at the incision site, you'll need to keep it dry for at least 24 hours after the procedure.

The sample from your biopsy will be tested in a laboratory. You may receive a call to see your doctor and discuss the results when they have been processed. A number of medical conditions can cause an abnormal bone marrow biopsy result, including anemia, bone marrow diseases, and certain types of cancer. To confirm the diagnosis or to determine disease progression, follow-up tests may be required. Your physician will talk to you about the next steps you should take.

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