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Last Updated on November 17, 2025 by Ugurkan Demir
Diagnosing diseases like blood disorders often needs a close look at the bone marrow. At Liv Hospital, we use bone marrow aspiration to find the root causes of blood-related issues.
It’s important for both patients and doctors to know about the procedure. The most common place for bone marrow aspiration is the iliac crest. This is because it’s easy to get to and has lots of marrow.
We’ll show you the important parts of the bone marrow aspiration procedure. This includes how to position the patient and a detailed step-by-step guide.
Bone marrow aspiration is a key medical procedure. It involves taking a sample of bone marrow for tests. This is important for diagnosing and tracking blood and marrow diseases, including some cancers.
Bone marrow aspiration uses a needle to take a sample from the bone. Its main goal is to diagnose and track blood and bone marrow issues. It helps find the cause of anemia, infections, and some cancers like leukemia.
This procedure is often done with a bone marrow biopsy. Both take samples from the bone marrow, but for different reasons and with different goals.
Bone marrow aspiration and biopsy are similar but not the same. Aspiration takes a liquid sample of marrow for cell analysis. A biopsy removes a small bone core with marrow for a detailed look at the marrow’s structure.
| Procedure | Sample Type | Primary Use |
| Aspiration | Liquid marrow sample | Cellular analysis, detecting abnormalities in cell composition |
| Biopsy | Core of bone tissue with marrow | Detailed examination of marrow structure and architecture |
Bone marrow tests, through aspiration and/or biopsy, provide a lot of information. They are key in diagnosing and staging blood cancers like leukemia and lymphoma. They also help with unexplained low blood cell counts, infections, and metabolic disorders, and track treatment responses in blood cancer patients.
The diagnostic power of bone marrow tests is vital in hematology and oncology. They give direct insights into the bone marrow’s health, helping make accurate diagnoses and treatment plans.
Doctors use bone marrow exams to find and treat many diseases. They decide to do this test based on the patient’s health and what they need to know.
One main reason for this test is to check for unexplained cytopenias. These are conditions like anemia, low white blood cells, or low platelets. The test helps find out why these problems happen, like if the marrow isn’t working right.
Bone marrow exams are key for diagnosing and staging blood cancers. They help find out how bad the cancer is and what kind it is. This info is vital for planning treatment.
Doctors also use this test to check for infections in the marrow, like tuberculosis. It’s also helpful for diagnosing metabolic disorders that affect the marrow, like Gaucher’s disease.
There are other times when this test is needed. For example, to look into unexplained spleen swelling, unknown fevers, or to stage some cancers. It’s also used for patients suspected of having certain blood disorders.
Bone marrow aspiration can be done at several sites, each with its own benefits and challenges. The site chosen depends on the patient’s age, body shape, and the procedure’s needs.
The posterior iliac crest is the top choice for bone marrow aspiration. It’s easy to get to and has a lot of marrow. The anterior iliac crest is also an option, mainly when the posterior site is hard to reach.
Both sites are safe and simple for getting bone marrow samples. The choice between them often depends on the patient’s position and the doctor’s preference.
Sternal aspiration is used in adults but is less common. It carries a risk of complications. It needs careful technique and precautions to avoid problems.
The sternum is hard to use because it’s thin and close to important structures. It’s not the first choice unless other sites can’t be used.
In infants, the tibia is the best site for bone marrow aspiration. It’s easy to access and safe. This site is great for early diagnosis in babies.
The tibial aspiration technique must consider the baby’s anatomy and the procedure’s needs. This ensures safety and success.
In some cases, other sites might be used for bone marrow aspiration. This could be other bones with marrow cavities, based on the patient’s condition and clinical needs.
Choosing an alternative site needs a detailed look at the patient’s anatomy and the procedure’s risks.
| Anatomical Site | Patient Group | Advantages | Considerations |
| Posterior Iliac Crest | Adults and Children | Accessible, abundant marrow | Patient positioning required |
| Anterior Iliac Crest | Adults and Children | Alternative to the posterior crest, relatively safe | May require different patient positioning |
| Sternum | Adults | Accessible in certain positions | Risk of sternal puncture, not preferred |
| Tibia | Infants | Easy access, relatively safe | Limited to infants, a specific technique is required |
Bone marrow aspiration needs precise patient positioning for the best results. The position depends on where the aspiration is done.
The prone position is common for posterior iliac crest aspirations. Patients lie on their stomachs, making it easy to reach the posterior iliac crest. This position is comfortable for patients and keeps the area stable for the procedure.
For some posterior iliac crest aspirations, the lateral decubitus position is used. In this setup, patients lie on their side. This is helpful when the prone position is not possible. Adjustments are needed to make sure the iliac crest is reachable.
The supine position is used for aspirations from the anterior iliac crest and sternum. Patients lie on their backs. This position is great for aspirations needing access to the front of the body. It’s important to make sure the patient is comfortable and the area is clean.
Pediatric patients need special care because of their small size and possible anxiety. Gentle and careful positioning is key. Sedation or distraction techniques might be needed. The child’s comfort and safety are the top priority.
To do a bone marrow aspiration safely and well, you need special equipment. Getting everything ready is key to a good outcome and accurate results.
Choosing the right needle is very important. Aspiration needles get marrow samples, while biopsy needles take core biopsies. The type you pick depends on the procedure’s needs and the patient’s health.
To make the procedure less painful, local anesthesia is used. Lidocaine is often the choice. You also need antiseptic solutions and sterile drapes to keep everything clean.
Getting and keeping the bone marrow sample right is key. You’ll need EDTA tubes for the aspirate and formalin containers for the biopsy.
Healthcare workers need personal protective equipment (PPE) to stay safe. This includes gloves, masks, and gowns.
The success of a bone marrow aspiration procedure depends a lot on good preparation before it starts. Doctors carefully check the patient to make sure the procedure is safe and works well.
Looking closely at the patient’s medical history is key. It helps find any risks or problems with the bone marrow aspiration. Doctors check the patient’s main health issue, recent treatments, and any medicines that might affect the procedure.
Key elements to review include:
Before starting the bone marrow aspiration, some tests are done to check the patient’s blood clotting and health. These tests are a complete blood count (CBC), prothrombin time (PT), and partial thromboplastin time (PTT).
It’s important to look at these test results to:
Getting informed consent is a big step before doing a bone marrow aspiration. This means explaining the procedure, its risks and benefits, and other options to the patient.
The informed consent discussion should cover:
Telling the patient what to expect during and after the procedure can help them feel less anxious. This includes explaining the procedure steps, what they might feel, and how to care for themselves after.
Good patient education means:
Finding the right spots for a bone marrow biopsy is key. We’ll show you the important landmarks and how to find them.
The posterior superior iliac spine (PSIS) is a must for bone marrow tests. It’s found at the back of the iliac crest. To find it, we feel the iliac crest’s back until we hit a hard spot. This spot is important for getting to the bone marrow.
The anterior superior iliac spine (ASIS) is also very important. It’s at the front of the iliac crest. We find it by tracing the iliac crest forward. The ASIS helps us know where to take the bone marrow sample.
When doing a biopsy on the sternum, knowing the landmarks is vital. The sternum is flat, and the manubriosternal junction is a key spot. We must be careful not to go too deep, as it could cause serious harm.
Palpation is a skill we use to find the right spots for the biopsy. We use our fingers to feel the bones and find the landmarks. It takes practice to get good at it, but it’s essential for the procedure.
| Landmark | Location | Significance |
| Posterior Superior Iliac Spine (PSIS) | Posterior aspect of the iliac crest | Common site for bone marrow aspiration and biopsy |
| Anterior Superior Iliac Spine (ASIS) | Anterior aspect of the iliac crest | Reference point for anterior iliac crest procedures |
| Manubriosternal Junction (Angle of Louis) | Sternum | Key landmark for the sternal bone marrow biopsy |
A successful bone marrow aspiration procedure needs careful site preparation and precise needle insertion. We will guide you through the essential steps to ensure a safe and effective procedure.
The first step is to prepare the site. We identify the best spot, usually the posterior or anterior iliac crest. The area is cleaned with an antiseptic solution and draped to keep it sterile.
Administering local anesthesia is key to reducing patient discomfort. We use lidocaine to numb the skin, subcutaneous tissue, and periosteum.
The needle insertion technique requires precision and control. We use a bone marrow aspiration needle with a stylet to penetrate the cortex.
Key steps include:
Once the needle is in place, we aspirate the bone marrow. The aspiration process involves creating negative pressure to draw marrow into the syringe.
Important considerations:
By following these steps, we can ensure a successful bone marrow aspiration procedure. This provides a high-quality sample for diagnostic analysis.
Handling bone marrow specimens with care is key. It keeps the sample good for tests. This is vital for making the right diagnosis and treatment plan.
Making high-quality smears from bone marrow is very important. Smears should be made right away or kept in a special tube with EDTA. This keeps the sample fresh. The process involves spreading the sample thinly and evenly on slides, then letting them dry before staining.
Key steps in smear preparation include:
After making smears, fixing and transporting the samples is next. Fixation keeps the cells intact. Transport makes sure the samples get to the lab in the best shape.
Fixation methods may include:
Some tests are needed to fully understand the bone marrow sample. These include flow cytometry, cytogenetic analysis, and molecular studies.
| Special Study | Clinical Utility | Specimen Requirement |
| Flow Cytometry | Immunophenotyping of cells | Fresh specimen in EDTA |
| Cytogenetic Analysis | Detection of chromosomal abnormalities | Sterile specimen in heparin |
| Molecular Studies | Detection of genetic mutations | Specimen in EDTA or frozen |
Keeping accurate records is very important. It helps track the sample from start to finish. This includes patient details, type of sample, and any special handling or testing instructions.
Bone marrow aspiration is usually safe, but knowing the risks is key. Success depends on choosing the right patient, finding the right spot, and doing the procedure carefully.
Problems like too much bleeding, infection, and pain can happen. Excessive bleeding can be stopped with pressure and special agents. Infection is rare but can be avoided with clean techniques.
“Preventing problems is the best way to manage them,” say doctors. “Knowing the risks and taking steps to avoid them can greatly improve results.”
Though rare, serious issues like hemorrhage, nerve damage, or bone marrow embolism can happen. It’s vital for doctors to know these risks and have plans for emergencies.
Some patients, like those with bleeding problems or on blood thinners, face higher risks. Taking steps like adjusting medications and watching them closely can help.
In conclusion, keeping patients safe during bone marrow aspiration needs a detailed plan. This includes checking them before and after the procedure.
We’ve covered the key steps for a successful bone marrow aspiration. The success of this procedure relies on good patient prep, finding the right spot, and careful technique. Making sure procedural success happens means paying close attention to how the patient is positioned and the tools used.
Following these guidelines helps healthcare teams give the best care and get high-quality samples. This is key to making accurate diagnoses and treatment plans in many blood and cancer cases.
In the end, a well-done bone marrow aspiration helps patients get better care and more accurate tests. By focusing on careful technique and putting the patient first, we make sure these procedures are safe and effective.
Bone marrow aspiration is a medical test that takes a sample of bone marrow. It helps doctors check the bone marrow’s cells. This is to find blood disorders, cancers, and other marrow problems.
Doctors often take bone marrow from the back and front of the pelvis. They also use the sternum in adults and the tibia in babies.
The way a patient is positioned depends on where the marrow is taken. For the back of the pelvis, they lie on their stomach or side. For the front of the pelvis and sternum, they lie on their back.
Doctors do bone marrow tests to check for blood problems, diagnose cancers, and find infections. They also use it for other conditions that need marrow analysis.
You need special needles, anesthesia, and cleaning supplies. Also, tools for collecting the sample and protecting yourself are important.
First, the area is cleaned and numbed. Then, a needle is inserted to take out the marrow. The sample is sent to the lab for tests.
Risks include bleeding, infection, nerve damage, and not getting enough marrow. Serious but rare problems can happen, too. Patients at high risk need extra care.
The sample is treated carefully to avoid contamination. It’s then prepared for lab tests, including making slides and fixing the sample.
Aspiration takes a liquid marrow sample. A biopsy removes a solid piece of bone and marrow. Both help doctors diagnose different things.
Patients should know their medical history and lab results. They need to understand the procedure and how to manage anxiety.
