What is a bone marrow biopsy?
Bone marrow is the area in our body which produces blood cells including the red blood cells, white blood cells and the platelets. Bone marrow is located in certain bones of the body and among them; the most accessible bone marrow to the outside is present in the hip bone. In instances where the peripheral blood films or blood reports show signs of abnormal cell developments such as in the case of leukemia or deficiencies like unexplained anemia, clinicians have to exclude any abnormalities in the place of its origin, which is the bone marrow. The method involved in examining the tissues from the bone marrow is to obtain a sample of the same and the process of obtaining such a piece of tissue is known as a bone marrow biopsy.
How is a bone marrow biopsy performed?
As mentioned earlier, the easiest accessible place to obtain a bone marrow sample is from the pelvic bone or the hip bone and this is done with the help of a bone marrow needle. The needle is relatively wide when comparing a normal injection needle but is half the size of a normal pencil. Following sedating the patient by giving oral agents such as anxiolyitcs, the patient has to lie on his or her stomach. The doctor will clean the upper buttock area with an antiseptic solution and will inject an anesthetic agent to the site to keep pain sensation at minimal levels during the procedure. Following this, the biopsy needle will be inserted through a cut made on the surface of the skin and will be pushed into the bone through its outer covering. Once it is inside, the first sample is collected through aspiration and it will be in a liquid form and a second sample is obtained which will be the core biopsy itself. After obtaining the sample, the biopsy needle will be withdrawn and pressure will be applied to the area to control bleeding for few minutes. Lastly, a pressure bandage will be applied to the biopsy site.
What are the possible complications after a bone marrow biopsy?
When talking about complications, it should be emphasized that, any serious outcomes following a bone marrow biopsy are extremely rare and in many of the studies it was ranging from 0.05% - 0.08%. But, in theory, there are several complications which are possible but could be minimized if proper measures to counteract them are undertaken.
The most important complication following a bone marrow biopsy is the occurrence of bleeding and this is most notable in instances where the patient is poorly assessed on his or her blood clotting ability. Furthermore, such bleeding can also take place when a person is on blood thinning agents which should ideally be stopped at least in the day before.
Secondly, if there are infections in the vicinity of the bone marrow site, there is a risk of introducing infections into the bone and to the surrounding tissues. But, with the use of antiseptic solutions and avoiding places of possible infections such infections are unlikely to happen in most instances.
Reactions to anesthetic agent or other medications used in the procedure will be another important issue although obtaining a detailed medical history can often reveals such allergic manifestations in the past.
Perhaps the most common and the harmless of all complications would be the local soreness which usually lasts for about 24 – 48 hours.