Powered bone marrow biopsy procedures produce larger core specimens, with less pain, in less time than with standard manual devices

Abstract

Bone marrow sampling remains essential in the evaluation of hematopoietic and many non-hematopoietic disorders. One common limitation to these procedures is the discomfort experienced by patients. To address whether a Powered biopsy system could reduce discomfort while providing equivalent or better results, we performed a randomized trial in adult volunteers. Twenty-six subjects underwent bilateral biopsies with each device. Core samples were obtained in 66.7% of Manual insertions; 100% of Powered insertions (P=0.002). Initial mean biopsy core lengths were 11.1±4.5 mm for the Manual device; 17.0±6.8 mm for the Powered device (P<0.005). Pathology assessment for the Manual device showed a mean length of 6.1±5.6 mm, width of 1.0±0.7 mm, and volume of 11.0±10.8 mm(3). Powered device measurements were mean length of 15.3±6.1 mm, width of 2.0±0.3 mm, and volume of 49.1±21.5 mm(3) (P<0.001). The mean time to core ejection was 86 seconds for Manual device; 47 seconds for the Powered device (P<0.001). The mean second look overall pain score was 33.3 for the Manual device; 20.9 for the Powered (P=0.039). We conclude that the Powered biopsy device produces superior sized specimens, with less overall pain, in less time.

Keywords: bone marrow biopsy; core biopsy; powered biopsy.; trephine biopsy.

Figure 1

The powered bone marrow biopsy system. The power driver and biopsy needle components of the OnControl powered bone marrow sampling system.

Figure 2

Manual bone marrow biopsy needle. This shows the condition of the manual needle following insertion into a patient with hard bones.

Figure 3

Biopsy core specimens. These are typical examples of bone marrow core specimens obtained following bilateral bone marrow biopsy procedures. Upper specimen is from Manual device and lower specimen is from Powered device.