A bone marrow exam is a test that checks to see how well your bones are producing red or white blood cells. The marrow of your bones, which is the spongy part in the center of some of your larger bones, is responsible for producing red and white blood cells. During a bone marrow biopsy, a doctor will extract a small piece of the more solid part of the marrow using a needle. During a bone marrow aspiration, the doctor extracts the more liquid part of the marrow. Generally these are both done at the same time and can help diagnose or monitor vascular and marrow diseases, as well as certain cancers.
Bone marrow exams are a fairly simple procedure. The exam itself takes about 10 minutes, but the whole procedure, including preparation and post-procedure care takes a total of 30 minutes. These procedures can be performed at a hospital, clinic, or doctor’s office and are usually ordered by a hematologist or oncologist and performed by interventional radiologists or oncologists.
Before the procedure is conducted, your doctor will check your heart rate and blood pressure before giving you an anesthetic. In most cases, only local anesthesia is required, as the only sensitive part in bone is its outer lining called periosteum. At Premier Vein and Vascular Center, the periosteum of bone is numbed using ultrasound guidance which makes the procedure virtually painless after administration of local anesthetic. An IV anesthetic in order to partially or totally sedate the patient is also used to further alleviate anxiety and any discomfort.
Next, the procedure site is cleaned. The site is usually located at the top ridge on the front of a hip bone, but can sometimes be collected from the back of the hip. The patient is asked to lay on their back and then covered with a clean sterile cloth so only the procedure site is visible.
The aspiration test is usually conducted first, making a small cut and inserting the needle to reach the bone. Once the needle reaches bone, the doctor extracts some of the liquid. In rare cases, fluid is not extracted and the needle must be moved to another location. Several samples of the liquid marrow may be taken and the doctor will examine them to ensure the samples are viable for testing. The biopsy test uses a larger needle to extract some of the solid marrow.
Once both tests are complete, the needles are removed and pressure is applied to the incision to stop any bleeding. It is then bandaged up and the patient will be asked to lie on their back for 10 to 15 minutes while continuing to apply pressure to the incision site. Once the patient feels ready, they can get up and continue on with their day as normal. If the patient opts for an IV anesthetic over the local, they will need someone to drive them home and then rest for 24 hours.
The procedure site may feel tender for a couple of days after the exam, but your doctor may recommend some painkillers such as Tylenol. It is also recommended that the patient refrain from any rigorous exercise for a couple of days to reduce discomfort and possible bleeding. Keep the bandage on and dry for 24 hours after the exam. That means you cannot shower, bathe, or swim during that time. If the incision bleeds through your bandage and doesn’t stop when pressure is applied, you have a persistent fever, or increasing pain, swelling, redness, or drainage around the procedure site, contact your doctor.