Bone Marrow Aspiration and Bone Biopsy

Examination of the bone marrow is a valuable test to diagnose blood disorders. A bone marrow biopsy takes a sample of bone and a small amount of fluid and cells from inside the bone. A bone marrow aspiration removes only the marrow. Bone marrow aspiration and bone biopsies are used to stage different disorders of the blood, such as leukemia. Staging will help your caregiver understand how far the disease has progressed.

The tests are also useful in diagnosing:

  • Fever of unknown origin (FUO).

  • Bacterial infections and other widespread fungal infections.

  • Cancers that have spread (metastasized) to the bone marrow.

  • Diseases that are characterized by a deficiency of an enzyme (storage diseases). This includes:

  • Niemann-Pick disease.

  • Gaucher disease.

PROCEDURE

Sites used to get samples include:

  • Back of your hip bone (posterior iliac crest).

  • Both aspiration and biopsy.

  • Front of your hip bone (anterior iliac crest).

  • Both aspiration and biopsy.

  • Breastbone (sternum).

  • Aspiration from your breastbone (done only in adults). This method is rarely used.

When you get a hip bone aspiration:

  • You are placed lying on your side with the upper knee brought up and flexed with the lower leg straight.

  • The site is prepared, cleaned with an antiseptic scrub, and draped. This keeps the biopsy area clean.

  • The skin and the area down to the lining of the bone (periosteum) are made numb with a local anesthetic.

  • The bone marrow aspiration needle is inserted. You will feel pressure on your bone.

  • Once inside the marrow cavity, a sample of bone marrow is sucked out (aspirated) for pathology slides.

  • The material collected for bone marrow slides is processed immediately by a technologist.

  • The technician selects the marrow particles to make the slides for pathology.

  • The marrow aspiration needle is removed. Then pressure is applied to the site with gauze until bleeding has stopped.

Following an aspiration, a bone marrow biopsy may be performed as well. The technique for this is very similar. A dressing is then applied.

RISKS AND COMPLICATIONS

  • The main complications of a bone marrow aspiration and biopsy include infection and bleeding.

  • Complications are uncommon. The procedure may not be performed in patients with bleeding tendencies.

  • A very rare complication from the procedure is injury to the heart during a breastbone (sternal) marrow aspiration. Only bone marrow aspirations are performed in this area.

  • Long-lasting pain at the site of the bone marrow aspiration and biopsy is uncommon.

Your caregiver will let you know when you are to get your results and will discuss them with you. You may make an appointment with your caregiver to find out the results. Do not assume everything is normal if you have not heard from your caregiver or the medical facility. It is important for you to follow up on all of your test results.