Bone Marrow Biopsy: Procedure, What to Expect & the Risks

A bone marrow biopsy is a procedure that can last up to 60 minutes. Bone marrow is a spongy tissue within your bones. It houses the stem cells and blood vessels that facilitate the production of:

• Red blood cells and white blood cells
• Fat
• Platelets
• Bone, and
• Cartilage

There are two types of marrow in the bone: red and yellow marrow. The red marrow is present in the flat bones, like vertebrae and hip. As you get older, your marrow becomes more yellow due to increased fat cells. Your healthcare provider will extract the red marrow, mainly from the back of the hip bone. The sample obtained will be analyzed for any blood cell abnormalities.

The laboratory to which your marrow is sent will analyze the marrow to make healthy blood cells. If it isn’t, the result will show the cause. It may be a cancer, an infection, or a bone marrow disease in most cases.

This article gives an in-depth discussion about a bone marrow biopsy and what you should expect during and after the procedure.

Why a bone marrow biopsy?

Your healthcare provider may ask you to do a bone marrow biopsy if your blood tests show that you have very high or low levels of red or white blood cells. With a biopsy, your doctor can determine what’s causing these abnormalities, which may include:

• A low red blood cell count, or anemia
• Infection
• Fever whose origin is unknown
• Bone marrow diseases, such as myelodysplastic syndrome or myelofibrosis
• Hemochromatosis (a genetic disorder characterized by buildup of iron in the blood)
• Blood or bone marrow cancers, such as lymphomas or leukemia
• Blood cell conditions, like thrombocytopenia, leukopenia, or polycythemia

These conditions can affect the production of red blood cells in your body and the levels of your blood cell types.

Your healthcare provider may also call for a bone marrow test to determine the extent to which a disease has progressed, the stage of cancer, or even monitor how effective a particular treatment is.

What are the risks associated with a bone marrow biopsy?

Every medical procedure has associated some form of risk. However, a bone marrow test has very minimal complications. According to The British Society of Hematology, less than 1 percent of bone marrow tests result in adverse events. The significant risk associated with this procedure is excessive bleeding or hemorrhage.

Other complications that may be associated with this procedure include:

• Infection
• Allergic reaction to anesthesia
• Persistent pain at the site of biopsy

You must consult your healthcare provider before a biopsy if you are taking medication or have an underlying health condition, especially if it makes you bleed more.

Preparing for a bone biopsy

The first step in getting ready for a bone biopsy is sharing your concerns with your healthcare provider. It would help if you shared all of the following with your doctor:

• Any supplements or medications you are taking
• Your medical history (essential for those that have an account of bleeding disorders)
• Any sensitivities or allergies to anesthesia, tape, or other substances
• If you are pregnant
• If you are anxious about the procedure and in need of medication to help you relax

It is best to have someone with you on the day that your bone marrow biopsy will take place. This is most important if you are getting sedatives. Do not drive after taking these medications. They will make you feel drowsy.

Follow all instructions given by your healthcare provider before the procedure. Do not stop taking a medication unless instructed by your doctor.

Get a good night’s rest to ease your tension before the biopsy.

Preparing for pain

Studies have shown that pain associated with biopsy is usually short-lived and more petite than anticipated. It is reported that the pain is connected to the difficulty and duration of a biopsy. Biopsies done in less than 10 minutes usually have very little pain than those that take longer.

Another factor to be considered is your anxiety level. According to the studies, people familiar with their procedures experience less pain.

How is a bone marrow biopsy done?

A biopsy can be performed in a clinic, a hospital, or a doctor’s office. The procedure is usually performed by a doctor specializing in cancers or blood disorders (an oncologist or a hematologist, respectively). The actual biopsy typically takes 10 minutes.

Before the procedure, you will wear a hospital gown and check your blood pressure and heart rate. Next, you may be asked to lie on your stomach or sit on your side. Your doctor will then apply a local anesthetic to your skin and the bone to numb the area where the biopsy will be done. Most bone marrow biopsies are taken from the chest bone or the ridge of the rear of your hip bone.

You will feel a slight sting as the anesthetic is injected. This is because a small incision will be made to allow the easy passage of a hollow needle through your skin.

The needle penetrates your marrow and collects your red marrow. However, it never gets close to your spinal cord. As a result, you may feel slight discomfort or dull pain as the needle penetrates your bone.

After the biopsy, your doctor will apply pressure to the area to stop bleeding, after which the incision will be bandaged.

What happens after a biopsy?

You may feel a little pain for a week or thereabouts after the procedure. However, the fact is that most people may not feel any pain. Over-the-counter pain relievers may be recommended to help manage your pain. The incision wound must be kept dry for at least 24 hours after the procedure.

Avoid activities that will stress you or cause your wound to open. Consult your healthcare provider immediately if you experience any of the following:

• Swelling
• Increased pain
• Excess bleeding
• Fever
• Drainage

It may take between one to three weeks to get your results. However, your healthcare provider may arrange a follow-up appointment to share your findings once you get your results.

Tonika Bruce

Tonika Bruce, also known as The Network Nurse, is a multi-talented individual with a career spanning over 20 years. She’s a Registered Nurse, speaker, author, and advocate for change, excelling in business building and team development. Tonika holds two Master’s degrees in Nursing and Business Administration, (MSN & MBA) and is currently pursuing her Doctorate of Nursing Practice in Executive Leadership.

Her expertise extends to various fields such as nursing, entrepreneurship, business, basketball coaching, and executive leadership. She is a published author of “Relentless Pursuit: Proven Tips for Unlocking Your Potentials, Limitless Success and Post COVID Syndrome: A Guide to Repositioning the Nursing Profession for A Post COVID Era”. Currently, Tonika is working on Thrudemic, an anthology examining the impact of the coronavirus pandemic on medical professionals and patients.

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