Procedure Guide

Bone Marrow Biopsy

An overview for this procedure is not yet available.

Step-by-step guidance on how to perform Bone Marrow Biopsy. Review tools, techniques, pearls, and pitfalls on the BackTable Web App.

Pre-Procedure Prep


• Hematologic disorders such as leukemia, lymphoma, multiple myeloma, anemia, etc.


• Few if any
• Procedure can be performed in setting of thrombocytopenia
• Cellulitis at skin entry site or underlying soft tissue infection should prompt evaluation for different site

Pre-Procedural Evaluation

• H&P
• Prior imaging cross sectional imaging of the pelvis

Bone Marrow Biopsy Podcasts

Ep. 1

BM BX Devices: Jamshidi vs. OnControl

Discussion of preferences in bone biopsy needles.


Procedure Steps


Most common site for bone marrow biopsy is iliac wing.

CT Guidance Commonly Used

• Prone patient with posterior approach
• Advance needle along length of the iliac wing.
• For right iliac wing biopsy, operator stands on patient's left and skin entry site is midline with lateral trajectory
• Seat needle just beyond cortex. Occasionally, helpful to have mallet to assist with seating the needle beyond the cortex
• Remove inner stylet. Aspirate with large volume syringe (20 - 30 mL)
• Following aspiration, advance biopsy device without inner stylet into iliac wing 2-3 cm,
• Can be helpful to gently rock biopsy device to help capture specimen. Many devices have additional tools to assist with specimen capture

Following Successful Aspirate and Bone Biopsy

• Hemostasis with compression
• Apply sterile dressing
• Option to take final pictures confirming no immediate post operative complication



• Rare
• Bleeding is most common
• Injury to surround structures
• Patient's can be sore 2-3 days following procedure
• Inadequate sample


• 15 minutes bedrest if local only
• Often times, moderate sedation will necessitate more recovery time than actual biopsy

Bone Marrow Biopsy Demos

Arrow OnControl Bone Marrow Aspiration & Biopsy Procedure

A demonstration of bone marrow aspiration and biopsy using the Arrow(R) OnControl(R) System.

Arrow OnControl Bone Marrow Biopsy Procedure Video

Dr. Kevin Rice performs and shows us a video using the Arrow OnControl bone marrow biopsy system. Dr. Rice says that using the Arrow OnControl system, the biopsy is more comfortable for the patient, faster, and a larger sample is available for the pathologist.

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BM BX Devices: Jamshidi vs. OnControl


Demo Video

Arrow OnControl Bone Marrow Biopsy Procedure Video


Demo Video

Arrow OnControl Bone Marrow Aspiration & Biopsy Procedure

Join The Discussion


[1] Cohen MG, McMahon CJ, Kung JW, Wu JS. Comparison of Battery-Powered and Manual Bone Biopsy Systems for Core Needle Biopsy of Sclerotic Bone Lesions. AJR Am J Roentgenol. 2016;206(5):W83‐W86. doi:10.2214/AJR.15.15067
[2] Lee RK, Ng AW, Griffith JF. CT-guided bone biopsy with a battery-powered drill system: preliminary results. AJR Am J Roentgenol. 2013;201(5):1093‐1095. doi:10.2214/AJR.12.10521
[3] BackTable, LLC (Producer). (2017, April 14). Ep 1 - BM BX Devices: Jamshidi vs OnControl [Audio podcast]. Retrieved from

Disclaimer: The Materials available on are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients.