Frequently Asked Questions About Bone Marrow Biopsies

My doctor wants me to have a bone marrow biopsy and aspiration because I have low blood counts. What is a bone marrow biopsy and aspiration? Is it going to hurt?

A bone marrow biopsy and aspiration may be performed during the work up of anemia (low blood) or for other cell abnormalities detected in blood. It is also used to determine whether you have bone marrow disease secondary to cancer or toxic agents. The biopsy is performed on the back hipbone (posterior iliac crest). The patient lies face down in bed and a long needle about the size of a thick pencil lead is inserted through the skin and into the bone. The deeper liquid part of the bone (marrow) is then aspirated into a syringe and processed by the pathologist. A core of bone is removed and also processed by the pathologist.

The bone marrow biopsy was traditionally performed with the use of only local anesthetics (lidocaine). In fact many institutions still use just local anesthetics for this procedure. This minimal attempt to relieve pain is what has given this common and important procedure a bad reputation.

Here at SCMC, the pathologists perform bone marrow biopsies in our Same Day Surgery Department. We routinely apply conscious sedation techniques with the use of intravenous medications to address anxiety and pain. Most of our patients end up sleeping for 15 to 20 minutes while we perform our bone marrow biopsy. Most have no recollection of the procedure and don’t experience any pain. The medications that we use are very short acting, allowing the patient to go home after they are observed for about an hour. Throughout the entire procedure, one of our experienced Same Day Surgery nurses will attend to your needs and keep a close eye on your vital signs (pressure, oxygenations, pulse and respirations). We have had over ten years of experience in performing bone marrows in this manner and work as a team.

How do I prepare for a bone marrow biopsy?

If you desire conscious sedation with medication, you will be instructed to remain NPO (nothing by mouth) after midnight—no eating or drinking. This is because the medications we give may cause nausea and vomiting and we want to limit any chance of your aspirating the emesis. Also you should arrange for a ride home as the medications, although short acting, can still impair your reflexes and driving could be hazardous. The Same Day Surgery Department will give you additional information prior to your scheduled bone marrow biopsy.