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Bone Marrow Biopsy Procedure

The bone marrow biopsy procedure is a minimally invasive technique used to evaluate bone marrow health and diagnose conditions such as leukemia, lymphoma, anemia, or other blood-related disorders. Performed under local anesthesia, this procedure involves extracting a small sample of bone marrow, typically from the hip bone, for detailed laboratory analysis. It is an essential diagnostic tool that helps healthcare providers understand the cause of abnormal blood counts and develop targeted treatment plans. The bone marrow biopsy procedure is a safe and effective method, offering critical insights into hematologic health while ensuring patient comfort throughout the process.

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Ep 1 BM BX Devices: Jamshidi vs. OnControl with Dr. Aaron Fritts and Dr. Christopher Beck

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Pre-Procedure Prep

Bone Marrow Biopsy Indications

• Hematologic disorders such as leukemia, lymphoma, multiple myeloma, anemia, etc.

Contraindications

• Few if any
• A bone marrow biopsy procedure can be performed in setting of thrombocytopenia
• Cellulitis at skin entry site or underlying soft tissue infection should prompt evaluation for different site

Pre-Procedural Evaluation

• H&P
• Prior imaging cross sectional imaging of the pelvis

Bone Marrow Biopsy Podcasts

Listen to leading physicians discuss bone marrow biopsy on the BackTable VI Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.

Episode #1

BM BX Devices: Jamshidi vs. OnControl

Listen to New Orleans IR Christopher Beck MD and Dallas IR Aaron Fritts MD discuss preferences in bone biopsy needles.

Bone Marrow Biopsy Procedure Steps

Site

• Most common site for a bone marrow biopsy procedure is iliac wing.

CT Guided Bone Marrow Biopsy

• Prone patient with posterior approach
• Advance needle along length of the iliac wing.
• For right iliac wing biopsy, operator stands on patient's left and skin entry site is midline with lateral trajectory
• Seat needle just beyond cortex. Occasionally, helpful to have mallet to assist with seating the needle beyond the cortex
• Remove inner stylet. Aspirate with large volume syringe (20 - 30 mL)
• Following aspiration, advance biopsy device without inner stylet into iliac wing 2-3 cm,
• Can be helpful to gently rock biopsy device to help capture specimen. Many devices have additional tools to assist with specimen capture

Following Successful Aspirate and Bone Biopsy

• Hemostasis with compression
• Apply sterile dressing
• Option to take final pictures confirming no immediate post operative complication

Post Bone Marrow Biopsy Care

Bone Marrow Biopsy Complications

• Rare
• Bleeding is most common
• Injury to surround structures
• Patient's can be sore 2-3 days following procedure
• Inadequate sample

Bone Marrow Biopsy Recovery Time

• 15 minutes bedrest if local only
• Often times, moderate sedation will necessitate more recovery time than actual biopsy

Bone Marrow Biopsy Demos

Watch video walkthroughs of bone marrow biopsy on the BackTable VI expanded content network.

Arrow OnControl Bone Marrow Aspiration & Biopsy Procedure

Arrow OnControl Bone Marrow Biopsy Procedure Video

References

[1] Cohen MG, McMahon CJ, Kung JW, Wu JS. Comparison of Battery-Powered and Manual Bone Biopsy Systems for Core Needle Biopsy of Sclerotic Bone Lesions. AJR Am J Roentgenol. 2016;206(5):W83‐W86. doi:10.2214/AJR.15.15067
[2] Lee RK, Ng AW, Griffith JF. CT-guided bone biopsy with a battery-powered drill system: preliminary results. AJR Am J Roentgenol. 2013;201(5):1093‐1095. doi:10.2214/AJR.12.10521
[3] BackTable, LLC (Producer). (2017, April 14). Ep 1 - BM BX Devices: Jamshidi vs OnControl [Audio podcast]. Retrieved from https://www.backtable.com/shows/vi

Disclaimer: The Materials available on https://www.BackTable.com/ are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.