Name of the Procedure:

Bone Marrow Aspiration and Biopsy (Code: G0364)

Summary

Bone marrow aspiration and biopsy is a medical procedure where a small sample of bone marrow is removed from the bone using a needle. This sample is then examined to diagnose or monitor certain health conditions.

Purpose

Bone marrow aspiration and biopsy are performed to diagnose and monitor blood and marrow diseases, including cancers such as leukemia and lymphoma. The goals are to analyze bone marrow function and detect abnormalities in blood cell production.

Indications

• Unexplained anemia
• Abnormalities in blood cell counts
• Diagnosis of blood-related cancers
• Fever of unknown origin
• Monitoring the status of known blood disorders

Preparation

• Fast for a certain period before the procedure, as instructed by the physician.
• Review current medications with the doctor; some may need to be adjusted or paused.
• Complete any requested blood tests or imaging studies to assess overall health.

Procedure Description

1. Prepping the Site: The skin over the chosen site (usually the hip bone) is cleaned and numbed with a local anesthetic.
2. Aspiration: A needle is inserted into the bone marrow cavity to withdraw a liquid marrow sample.
3. Biopsy: Using the same incision, a larger needle is inserted to take a solid marrow sample.
4. Completion: The samples are taken, and the site is bandaged.

Tools used include aspiration needles, biopsy needles, and local anesthetics. Sedation details, if applicable, will be tailored to the patient's needs, but local anesthesia is typically sufficient.

Duration

The procedure usually takes about 30-45 minutes.

Setting

This procedure is typically performed in a hospital, outpatient clinic, or specialized surgical center.

Personnel

• Hematologist or Oncologist
• Nurse or medical assistant
• Possible involvement of an anesthesiologist

Risks and Complications

• Common risks: discomfort or pain at the biopsy site, bleeding, and bruising.
• Rare complications: infection at the biopsy site, prolonged bleeding, and damage to surrounding tissues.
• Complication management involves proper wound care and monitoring for signs of infection or other issues.

Benefits

Provides crucial diagnostic information about bone marrow function and underlying diseases. Benefits are often realized shortly after analysis of the samples.

Recovery

• Post-procedure care includes keeping the site clean and dry, avoiding strenuous activities for a few days.
• Pain at the site can be managed with over-the-counter pain relievers as recommended by the doctor.
• Recovery is typically quick, with normal activities resuming within a couple of days.
• Follow-up appointments may be scheduled to discuss results and any further treatment.

Alternatives

• Blood tests: Less invasive but might not provide as detailed information.
• Imaging tests: Non-invasive but often less informative about marrow health.
• Pros of alternatives: Less invasive and no recovery time.
• Cons of alternatives: May be less accurate or comprehensive in diagnosing marrow-related conditions.

Patient Experience

During the procedure, the patient might feel pressure or discomfort, especially when the needle penetrates the bone. Afterward, there may be soreness or mild pain at the site, which typically subsides within a few days. The healthcare team will focus on pain management and ensuring patient comfort throughout and after the procedure.