Is a bone marrow biopsy painful

Author: Dr. med. habil. Gesche Tallen, created on: October 29th, 2009, editing: Maria Yiallouros, approval: Prof. Dr. med. Dr. H. c. G√ľnter. Henze, last changed: 04.06.2020

A bone marrow harvest must be performed if the diagnosis of a disease requires examination of the bone marrow. This is mainly the case with leukemia and lymphoma as part of the initial and follow-up diagnosis. In the case of various solid tumors, the bone marrow examination is used to determine the patient's disease stage (so-called staging).

Bone marrow can be obtained using a bone marrow puncture or, less commonly, a bone marrow punch biopsy. Below is a brief description of the two procedures.

Bone marrow puncture

In bone marrow aspiration, also called bone marrow aspiration, the doctor takes a small amount of bone marrow from the patient's posterior iliac crest bone. There the bone marrow is only separated from the skin by a relatively thin layer of bone so that it can be removed without any significant risk. With the help of a thin hollow needle, the doctor sucks a few milliliters of bone marrow into a syringe.

In older children, the puncture is performed under local anesthesia; a sedative may also be administered (sedation). A brief anesthetic may be useful for smaller children. This is to keep the pain that occurs when sucking in the bone marrow blood as low as possible.

The examination can be carried out on an outpatient basis and usually does not take longer than 15 minutes. Then the puncture site is stuck with a plaster and usually weighted down with a small sandbag for about half an hour. This prevents rebleeding. After that, the child can get up again and walk around. As a rule, pain is not to be expected.

Bone marrow punch biopsy

In rare cases, not enough bone marrow can be obtained with a bone marrow aspiration. In leukemia, for example, the leukemic cells can sometimes adhere to one another so strongly that they are difficult to process after removal for the subsequent examinations and therefore cannot be adequately assessed. In such cases, a so-called bone marrow punch biopsy must be performed for further clarification. In a bone marrow punch biopsy, the doctor uses a special, slightly thicker hollow needle to punch an approximately 2 cm long cylinder of tissue from the bone. This examination is always carried out under anesthesia.

Bone marrow exams

For which questions can the examination of the bone marrow be important? More information here