Last Updated on November 17, 2025 by Ugurkan Demir

Bone marrow aspiration is a key test for diagnosing and treating blood and marrow diseases.

At Liv Hospital, we focus on precision and safety in bone marrow aspiration and biopsy. These steps need skill, the right spot, and care for each patient. This ensures the best results for those getting bone marrow examination.

We’ll show you the main parts of bone marrow aspiration. This includes the best places for the test, how to position the patient, and the steps to follow.

Key Takeaways

• Understanding the importance of bone marrow aspiration in diagnosing blood and marrow diseases.
• Recognizing the need for precision and safety in bone marrow aspiration and biopsy procedures.
• Identifying the appropriate sites for bone marrow aspiration.
• Learning the correct patient positioning for the procedure.
• Familiarize oneself with the step-by-step process of bone marrow aspiration.

What is Bone Marrow Aspiration and Its Purpose

Bone marrow aspiration is a way to get a sample of bone marrow. It helps us find and track blood-related disorders. We take a liquid sample from the bone marrow and look at it under a microscope. This helps us see if there are any problems with the cells.

Definition and Clinical Significance

Bone marrow aspiration is a medical test that takes bone marrow from the body. The bone marrow is in some bones, like the hips and sternum. It makes blood cells. By looking at the bone marrow, we can see if it’s working right and making enough blood cells.

This test is important because it tells us about the health of the bone marrow. It helps us find problems like leukemia, lymphoma, and anemia. We can see the types and numbers of cells in the bone marrow.

Diagnostic and Therapeutic Applications

Bone marrow aspiration is used for both finding and treating problems. It helps us diagnose blood disorders and cancers. It also helps us collect healthy bone marrow cells for transplant in some treatments.

Often, we do bone marrow aspiration and biopsy together. This gives us a full picture of the bone marrow’s health. It helps us make accurate diagnoses and plan treatments.

Indications for Bone Marrow Examination

Bone marrow examination is key for diagnosing many diseases. It shows what’s happening in the bone marrow. This helps doctors understand and track several conditions.

Hematological Disorders

Hematological disorders often need a bone marrow test. These include anemia, leukemia, and lymphoma. A test can find out if anemia is caused by marrow problems.

Oncological Indications

Oncological conditions also require bone marrow tests. This is true for cancers like multiple myeloma and metastatic disease. The test shows how far the disease has spread and if treatment is working.

Other Medical Conditions

Other conditions also need bone marrow tests. This includes myeloproliferative neoplasms, aplastic anemia, and some infections or inflammation. These tests help doctors understand and treat these issues.

For more info on bone marrow tests, check out NCBI’s guide on bone marrow aspiration. Knowing about these tests helps improve patient care and accuracy in diagnosis.

Understanding BM Aspiration vs. Bone Marrow Biopsy

It’s important to know the difference between bone marrow aspiration and bone marrow biopsy. Both are used to check the bone marrow, but they do different things. They give different kinds of information.

Key Differences in Technique

Bone marrow aspiration takes out the liquid part of the bone marrow. It’s used to look at the cells. This helps diagnose and track blood disorders.

A bone marrow biopsy involves removing a piece of the solid bone marrow tissue. It shows more about the marrow’s structure and cells.

The method for aspiration is less invasive than biopsy. Aspiration uses a thin needle and a syringe to get the marrow fluid. A biopsy needs a bigger needle for a core sample of tissue.

When Both Procedures Are Needed

Often, both bone marrow aspiration and biopsy are done together. This gives a full view of the marrow’s health. It’s key for diagnosing and treating blood cancers like leukemia and lymphoma.

Together, they help doctors understand the marrow’s cells, structure, and any problems. This info is vital for making the right diagnosis and treatment plan.

We usually do both tests together. Bone marrow aspiration looks at the marrow cells. A bone marrow biopsy shows the marrow’s structure and cell count.

Essential Equipment and Materials

To do a bone marrow aspiration, we need special tools and materials. These help make the procedure safe and effective. We use a variety of tools to get accurate results.

Aspiration Needles and Devices

The main tool for bone marrow aspiration is the aspiration needle. It goes through the bone to get the marrow. Aspiration needles have different designs, like adjustable guards to control how deep they go.

Some needles are made just for bone marrow aspiration. They have a sharp tip and are strong to avoid bending or breaking.

We also use stylets and obturators to help the needle go through the bone. They also prevent clogging. The needle size and type depend on the patient’s age, size, and where we’re doing the aspiration.

Safety and Specimen Collection Supplies

We also use safety and specimen collection supplies. Sterile gloves, gowns, and drapes keep everything clean and prevent infection.

For collecting the specimen, we use aspiration syringes and collection tubes. These are made to handle the thick bone marrow. We also prepare slides for smearing the marrow for microscopic tests.

It’s important to make sure all equipment is sterilized. And that we have all the supplies we need. This helps the bone marrow aspiration procedure go smoothly.

Bone Marrow Aspiration Sites: Anatomical Overview

Choosing the right spot for bone marrow aspiration is key. The site picked affects how well the procedure goes and how comfortable the patient feels.

Posterior Iliac Crest: Primary Site

The posterior iliac crest is the top choice for bone marrow aspiration. This spot is favored because it’s easy to get to and has lots of marrow. It’s also a safe area, with little chance of harming nearby tissues.

Anterior Iliac Crest: Alternative Approach

The anterior iliac crest is a good backup when the posterior crest can’t be used. This site is great for patients with certain body shapes or past surgeries in the back of the pelvis.

Sternum and Other Alternative Sites

The sternum and other places, like the tibia (in babies) can also be used. The sternum is usually not used in kids because of the risk of a hole in the chest. Other sites are picked based on the patient’s age, body shape, and what the doctor needs.

Bone Marrow Biopsy Landmarks and Navigation

Finding the right spots for a bone marrow biopsy is key. We’ll show you the important landmarks and how to safely find them.

Identifying the Iliac Crest

The iliac crest is the top choice for bone marrow biopsies. We find it by feeling the top edge of the ilium.

Avoiding Neurovascular Structures

It’s vital to steer clear of nerves and blood vessels during the biopsy. We do this by knowing the area’s layout and placing the needle carefully.

Knowing the area’s layout is critical for a bone marrow biopsy. The iliac crest is the best spot, but it needs to be found exactly right.

Here are key points to consider when identifying the iliac crest:

• Locate the superior border of the ilium.
• Palpate the area to identify the crest.
• Mark the site for the biopsy.

By knowing and correctly identifying bone marrow biopsy landmarks, we can lower the risk of problems. This makes the procedure more likely to succeed.

Correct Position for Bone Marrow Aspiration

Getting a patient in the right position is key to a successful bone marrow aspiration. The right position makes it easier to reach the site, lowers the risk of problems, and keeps the patient comfortable.

Lateral Decubitus Position Technique

The lateral decubitus position is a common choice for bone marrow aspiration. The patient lies on their side with knees bent. This is great for reaching the posterior iliac crest.

• The patient lies on their side, often the left side for right-handed doctors.
• Knees are bent to keep the patient stable and make it easier to get to the site.
• The posterior iliac crest is found and ready for the procedure.

Prone Position Approach

The prone position is used for bone marrow aspiration, mainly for the posterior iliac crest or other back sites. The patient lies face down.

Key aspects of the prone position include:

1. The patient lies on their stomach, which helps reach back sites.
2. More support or adjustments might be needed to keep the patient comfortable and safe.
3. It’s important to avoid putting too much pressure on the chest and belly.

Position Modifications for Special Populations

Some patients need special positioning due to their health. For example, those with breathing issues might need a certain position to help them breathe better.

• Kids might need extra support and to be kept in place.
• People with muscle or bone problems might need their position adjusted.
• Pregnant women might need to avoid putting pressure on the vena cava.

Knowing and using the right positioning helps doctors do a safe and effective bone marrow aspiration for many patients.

Patient Preparation and Safety Protocol

Patient preparation and safety are key to the bone marrow aspiration process. It’s important to prepare patients well for their safety and the procedure’s success.

Pre-procedure Assessment

We do a detailed pre-procedure check before the bone marrow aspiration. We look at the patient’s medical history, current meds, and allergies. We also do a physical exam to spot any risks.

This check is vital to see if a patient needs extra care. For example, those with bleeding disorders might need special precautions to avoid bleeding.

Informed Consent Process

Getting informed consent is a big part of preparing patients. We make sure they know why the procedure is needed, what it involves, possible risks, and other options.

We have a detailed talk with the patient to answer any questions. This builds trust and makes sure they know what to expect before, during, and after the procedure.

Infection Control and Sterile Field Setup

Keeping the area clean is key to avoiding infections during the procedure. We follow strict infection control rules, like using sterile tools and washing hands properly.

Setting up a sterile area is also important. We make sure all tools and supplies are clean and the patient’s area is covered to keep it sterile.

By focusing on patient preparation and strict safety rules, we reduce risks in bone marrow aspiration. This makes the procedure safe and successful for everyone involved.

Step-by-Step Bone Aspiration Procedure at the Iliac Crest

The bone marrow aspiration at the iliac crest has several key steps. We will walk you through each stage, focusing on the most important parts.

Site Preparation and Antisepsis

Getting the iliac crest ready is vital for a good procedure. First, we find the posterior superior iliac spine (PSIS), a key spot. Then, we clean the area with an antiseptic solution and cover it with sterile drapes.

Antisepsis is very important to avoid infections. A medical expert says, “Keeping the area clean is key to avoiding problems during the procedure.”

“The risk of infection can be minimized by adhering to strict aseptic techniques during the preparation and execution of bone marrow aspiration.”

Local Anesthesia Administration

To make the procedure painless, we use local anesthesia. We usually choose lidocaine and inject it into the skin and deeper tissues around the PSIS. This keeps the patient comfortable during the whole process.

Using local anesthesia well is important for the patient’s comfort and cooperation.

Needle Insertion and Advancement Technique

The needle insertion is a key part of the procedure. We use a special needle that goes through the skin and into the iliac crest. We gently turn the needle to help it go through the bone.

After the needle is in, we remove the stylet and attach a syringe for aspiration.

Aspiration Process and Sample Collection

The aspiration process is when we take out the marrow with the syringe. We aim to get enough for tests. The sample is then sent for analysis, which might include cytological examination or flow cytometry.

Combined Bone Marrow Aspiration and Biopsy Procedure

Doing bone marrow aspiration and biopsy together helps doctors understand a patient’s health better. This method gives a detailed look at the bone marrow. It helps doctors make better treatment plans.

Sequential Approach

The procedure starts with aspiration, then biopsy. This order is best because aspiration doesn’t mess up the marrow. The biopsy then takes a sample from the undisturbed area.

Key Steps in the Sequential Approach:

• Preparation of the site and administration of local anesthesia
• Aspiration of bone marrow for cytological examination
• Biopsy to obtain a core sample for histological analysis

Core Biopsy Technique

The core biopsy technique is key to getting a good bone marrow sample. It uses a special needle to take a small piece of bone and marrow. This piece is then checked under a microscope.

Important Considerations for Core Biopsy:

Specimen Handling and Processing

It’s very important to handle and process bone marrow samples correctly. The aspirate and biopsy samples are treated differently. This is because they have different roles in patient care.

“The quality of the specimen is key to accurate diagnosis. Proper handling and processing are vital for getting good results.”

As noted by the experts.

Specimen Processing Steps:

1. Aspirate samples are smeared and stained for cytological examination
2. Biopsy samples are fixed, decalcified, and sectioned for histological analysis
3. Both samples are then checked by a pathologist for a full diagnosis

Post-Procedure Care and Complication Management

After bone marrow aspiration, it’s key to focus on post-procedure care and managing complications. This helps in a smooth recovery and avoids any issues.

Immediate Post-Procedure Monitoring

We keep a close eye on patients right after the procedure. We watch the area where the bone marrow was taken for any bleeding or swelling.

Vital signs are checked often to make sure everything is stable. We also look for any pain or discomfort that might need extra care.

Common Complications and Their Management

Even though bone marrow aspiration is usually safe, some complications can happen. These might include:

• Bleeding or hematoma at the aspiration site
• Infection
• Nerve damage
• Pain or discomfort

We deal with these issues quickly. For example, we use pressure dressings to stop bleeding. We also use clean techniques to prevent infection.

Patient Discharge Instructions

Before leaving, patients get clear instructions on how to care for themselves. This includes:

• Keeping the aspiration site clean and dry
• Monitoring for signs of infection or bleeding
• Managing pain with recommended analgesics
• Follow-up appointments for wound check and further evaluation

We stress the importance of following these instructions. This helps ensure a smooth and safe recovery.

Conclusion

Bone marrow aspiration is key in diagnosing and treating blood disorders. It’s often done at the iliac crest using a thin needle. The International Society of Laboratory Hematology has guidelines for reporting these samples accurately.

For more details, check out the National Center for Biotechnology Information.

We’ve covered the important steps and things to think about when doing bone marrow aspiration. Knowing the right techniques and what to watch out for helps doctors take better care of their patients. Combining bone marrow aspiration with biopsy gives a full picture of bone marrow health.

FAQ

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References

1. Lucas, J., & Chambers, A. R. (2023). Bone marrow aspiration and biopsy. In StatPearls. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559232/