Bone marrow puncture | Iliac crest

Bone marrow puncture

A bone marrow puncture can be used for diagnostic (sample collection) as well as therapeutic (collection of stem cells for stem cell transplantation) purposes. A bone marrow puncture is indicated, for example, in cases of suspected anaemia, leukaemia or bone marrow metastases from cancer. The bone marrow collection is carried out after a detailed clarification at the iliac crest under local or general anaesthesia.

Depending on the indication, the bone marrow donor can lie either on his stomach or on his side. The puncture is done with a needle and usually only small skin incisions are necessary. The aspirated bone marrow is then either examined with a microscope or used for stem cell transplantation.

The maximum amount that can be aspirated is defined by the weight of the patient. The cells of the bone marrow regenerate within a few weeks. A compression bandage is applied to prevent secondary bleeding.

After the procedure, the patient should remain under medical observation for at least one hour and then rest. Dangers of a bone marrow aspiration are infections of the puncture site or an inflammation of the bone marrow as well as the periosteum or the adjacent tissue. Pain similar to aching muscles can also occur after the procedure. In extreme exceptions, a fracture of the iliac crest may occur.

Iliac crest fracture

Bone fractures in the region of the iliac crest are very rare. They can occur as a result of a traumatic event (for example, a traffic accident) or due to pathological bone resorption processes (osteoporosis). Symptomatically, the bone fracture manifests itself through pain, which occurs especially during stress or movement and can radiate up to the navel.

Lying on the injured side also causes pain, which can lead to sleep disorders. In the region of the iliac crest, a haematoma or swelling can also be observed. If a fracture is suspected, a doctor should be consulted.

With the help of an ultrasound (sonography) or imaging (X-ray or computer tomography) the diagnosis can be confirmed. Depending on the degree of injury, the fracture is treated conservatively (bed rest) or surgically (stabilisation by plates). Pain medication should be considered if the patient has severe complaints. In case of surgery or bleeding, blood-thinning medication (ASS, coumarin derivatives …) should be avoided.