Bone marrow puncture indications and features of the procedure

Bone marrow puncture is performed in a hospital and clinic. The patient should undress before the procedure to the waist and lie with his back on the couch. Before sampling the tissue material around the puncture site (along the midline of the body at the level of 2-3 ribs), it is treated with an antiseptic and anesthetized with an anesthetic solution.

First, soft tissues are carefully pierced, then with a rotational movement, slightly pressing, a needle is inserted into the thickness of the sternum or other area. After that, the mandrin is removed from the needle and a syringe is put on. By pulling the piston of the syringe from the sternum, about 1 ml of bone marrow substance is taken. Next, the needle with the syringe is removed and the puncture site is sealed with a sterile dressing.

What happens after the procedure?

After the procedure, the patient should remain in the medical institution for another 20-30 minutes. If after this time nothing unexpected has occurred (bleeding, poor health, etc.), you can go home, preferably accompanied by relatives. At home, you should adhere to the doctor’s recommendations – do not wet the puncture site and treat it with antiseptics.

Material research

Bone marrow sampling is only the first step in the diagnosis. Further, the material must be investigated. The following methods are used for this:

  • microscopy (studying bone marrow tissue under a microscope with a count of the number of cells of each type);
  • histochemical analysis (study of the chemical properties of the collected material);
  • immunophenotyping (typing of bone marrow cells by protein molecules located on their surface);
  • cytogenetic tests (study of a chromosome set of bone marrow cells).

What does bone marrow puncture show? Based on the results of the studies, the doctor can judge whether there is a malignant process. If so, what type of leukemia or other cancer is diagnosed in the patient. In addition, a puncture can show whether the picture in the bone marrow has changed after treatment.

Possible complications

Bone marrow puncture can have the following consequences:

  • tissue infection;
  • a puncture of the sternum with damage to organs located behind it;
  • bleeding.

These complications rarely occur. If the procedure is performed by an experienced specialist, there should be no problems. The only thing that can appear even with the correct technique for performing all manipulations is a local allergic reaction to the applied anesthetics and antiseptics.

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Advantages and disadvantages

Puncture of bone marrow tissue has one big advantage – it is an opportunity to examine the bone marrow directly for malignant degeneration. The doctor as a result of the study receives information that is very important for making the correct diagnosis. In addition, the puncture does not require special preparation and can be repeated if necessary.

The main disadvantage of the study in question is the nuisance for the patient of the procedure for sampling the material.

Which doctor performs a bone marrow puncture?

The direction to the bone marrow puncture is given by hematologists and oncologists. Therapists do not make such appointments due to the narrow specificity of the study. The procedure is conducted by nurses who have undergone special training.

Does it hurt?

Puncture of the sternum or other bone is an unpleasant procedure, so it is most often performed with local anesthesia. Patients feel special discomfort during the suction of material into the syringe. But this is all bearable.

Bone marrow puncture is a study that can detect blood cancer and determine the type of leukemia with high accuracy. If the procedure is carried out by an experienced specialist, everything goes quickly and without complications. There is no alternative to this diagnostic method in medicine.

Shishkevich Vladimir
Shishkevich Vladimir
Orthopedic doctor, traumatologist
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Vladimir Shishkevich

Orthopedic surgeon, traumatologist, vertebrologist. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles. Diagnoses diseases of the musculoskeletal system, conducts treatment, monitors the healing process, recovery from injuries and operations, the application of immobilizing dressings, closed correction of dislocations and fractures.