Posterior Iliac BMB

I had mine in the hospital - an outpatient procedure. I was given a local anesthetic along with IV meds for pain and to calm me down. I was awake the entire time and had no discomfort during the procedure. The site was sore for a day or two but not a big deal.

Hello. I have had 4 Bone Marrow Biopsies, leading up to having a Bone Marrow Transplant on 7/2/26.
All four procedures were in hospital settings.

The first two Biopsy procedures were relatively easy and uneventful. I was given a local, prepped and total procedure time about 20 minutes. The site was mildly sore for 3 days and gradually went away a bruised area for about 10 days.

The third and fourth Biopsies were more uncomfortable and took longer to recover from. They were more difficult due to having advanced Myelofibrosis made it difficult for the doctor to get the needed fluid/tissue from the fibrous tissue for slides as needed.

I wish you all the best in your journey.

First I would like to say I’m sorry that you need to have a BMB - one because it’s needed to diagnose a possible disease and two because it’s an unfamiliar procedure, and both are scary.
I am a medical laboratory scientist that has worked in hospital laboratories for 38 years. I have also had a BMB in February. I can tell you my experiences on both sides.
My oncologist sent me to a hospital 2 hours away to have my biopsy. Our local hospital didn’t have interventional radiology, which she recommends over a physician office procedure. Radiology is used to guide the procedure and “hit the target”. It’s an outpatient procedure performed in a sterile operating room. You are fasting. You have conscious sedation - an IV using versed and fentanyl. You’re awake but don’t really care! Lidocaine is used as a topical anesthetic when making the incision. They used a cordless electric drill to drill into the bone. You can’t numb the bone though so I did feel it when they aspirated the marrow. Just a short sharp pain.
Procedure takes about 20 minutes. You recover for an hour in a room before discharge Bandage over the incision. Lovely nurses gave me a sandwich and juice in recovery. The area on your back is sore for about 3 days and I did not sleep on my back for a while. It will be bruised for about a week.
Experience assisting physicians at the hospital bedside (prepping the collected marrow samples for testing) - patients were lightly sedated, an auger type hand drill was used to drill into the marrow. It appeared somewhat painful for the patient and without radiology guidance there was a rare miss.
Ask how the physician performs the procedure in their office. Can you have interventional radiology procedure done at a hospital instead? A sterile operating room is my preference.
Good luck and I wish you the best outcome.
Barb

I've had nine. 8 awake and 1 with sedation. I do not like sedation, so opt to be awake. Key for me - Lidocaine is your friend!!! I had 4 in one month last October (was screening for a trial) and had to take 2 samples, first set came back unreadable so had to do a second.
Worst part is that lidocaine stings a bit, so a small amount is give to deaden the area, the remainder is done (for me they do about 10 ml). I feel pressure when they hit the bone and a kinda weird sensation when they aspirate the marrow. Then just cover and relax for an hour / dress the area and keep the area dry for 24-48 hours.
Key is just to stay relaxed - tension makes it worse (I know harder said that done).. Hopefully you get someone that has done many.
Good luck

@vszendrey88 Welcome to Mayo Clinic Connect! You have seen some good responses here. I myself have had 4 of these procedures. The first one I was definitely not impressed with my doctor's technique LOL. New town, new oncologist, and I am so impressed with my current oncologist. Very experienced, very gentle. I drive 2 hours each way to get to those appointments, and it was no problem for me to drive home right after! In my situation, I chose to have no sedation. Some localized discomfort, but not bad at all.

Each person will experience perhaps different things. But our stories are similar.

How soon is your procedure? What are they looking for?
Ginger

I had mine in hospital with IV sedation but awake. Some short pain when going in bone. I would opt for hospital instead of doctor office if that is an option.

I’ve had CMML/myelofibrosis for 10 years so I’ve had several of these. The last one wasn’t great. Because I’m 77 my bones have softened so they had trouble and had to try a few times to get a clean sample and the lidocaine started wearing off. The pain is sort of like really bad menstrual cramps. It still wasn’t that bad. But it is an invasive procedure so a hospital would be better.

Thank you everyone for your input. It was very helpful!
I had my procedure 6/24. It wasn’t too bad, not great though. My boyfriend was in the room with me and got all sweaty and almost passed out haha. He didn’t care for the crunching and popping sounds and seeing to specimen come out. Took it easy yesterday, but back at work today and I work in the OR so pretty sore.
Now is the hard part of waiting for results and the follow up appointment

I've had 4 BMBs. All were pain free. Two were done by Interventional Radiology, and I have no memory of injections or drilling or pain (IV rx given). Two were in my oncologist's office and she had excellent technique. There was no pain at all (except the tiniest of stings when she started). Yes, I could feel pressure once or twice, but it was totally pain-free. My husband observed and did not get queasy.
After the office procedures I sat up and we all went back to having a regular appointment. I never felt that sore that day, and successive soreness itself was trivial.
BUT my first BMB was sloppily done, per my very experienced leukemia doctor. The IR team must have let a student do it. The bone fragment was missing from one sample, and there was inadequate testing material to get meaningful results on the remainder. My diagnosis of AML was delayed a month. (I should have gotten another BMB almost immediately.)
Good luck to you! With experienced providers, BMB is not a traumatic event.

Hi @vszendrey88 I’m laughing out loud with the comment about your boyfriend…those tough guys aren’t always so tough. ☺️. BUT he gets major creds for being your moral support during the biopsy! That’s pretty sweet!

Now that your bone marrow biopsy is out of the way, it will take a week or so for all of the details from the biopsy and aspiration to be evaluated and returned to your doctor. If you don’t mind sharing a little more about yourself, what is your doctor looking for with the biopsy? Is there an indication of a blood condition they’re looking to diagnose?