Puncture of bone marrow and other punctures for medical and diagnostic purposes

Puncture is called a puncture of the organ. The procedure is performed for diagnostic or therapeutic purposes.

Puncture of bone marrow

The patient is made for his research, the donors - in order to obtain a healthy biological material. Puncture exposed to such bones as the iliac, epiphysis of the tibia, heel, and also sternum. In adults, the iliac crest and sternum are most often involved in the study. Puncture of the bone marrow can be performed even in the spinous process of the vertebra of the lumbar region. Due to the smaller thickness and density of the sternum in children, its puncture in this area is very dangerous. In childhood (including the earliest), bone marrow puncture should be predominantly performed in the tibia (its upper third).

The procedure is carried out with anesthesia, in the aseptic conditions of the operating room. Puncture of the bone marrow is carried out in the position of the patient lying on his back. Using a hollow needle, the sternum is pierced at the level of the third rib. A special puncture needle is equipped with a disc-limiter to control the depth of the puncture.

Under the microscope, a colored smear of the material is examined. This allows us to identify the presence of atypical cells and other changes. If there are bloody impurities in the puncture, the blood is removed with the help of filter paper or aspirated with a pipette. Such necessity is connected with that, the superfluous admixture in a material of peripheric blood does not allow to receive exact representation about structure of an osteal brain. If the biological material is too liquid, a leuco-concentration method is used. After separating the cells from the plasma, make smears from the sediment.

Puncture (biopsy) of the bone marrow is carried out for the purpose of diagnostic confirmation of metastases, ascertaining the causes of thrombocytosis, leukocytosis, anemia. This procedure also makes it possible to evaluate the effectiveness of the drug therapy used in blood diseases.

It is rare in medical practice to have complications with diagnostic puncture. As a rule, they can be associated with infection in the medullary cavity. When carrying out a sternum puncture, there is no chance of damage to large vessels. Only in case of gross non-observance of the technique of investigation, violations in the integrity of internal organs are possible.

Spinal puncture

This procedure is used for extraction with subsequent investigation of the CSF or for infusion of radiopaque or drug substances.

During the procedure, the needle is inserted into the subarachnoid space. Puncture can be performed at different levels of the spine. More often the puncture is carried out in the lumbar region, in rare cases in the thoracic region, near the large opening.

Lumbar puncture gives very valuable diagnostic data. Liquor obtained during the procedure may contain bloody or purulent impurities. This allows us to assume meningitis or subarachnoid hemorrhage. The cerebrospinal fluid can be transparent. Using a manometer (a glass tube bent at an angle, with the available centimeter divisions), it is determined by what pressure the liquor from the needle escapes: increased, normal or decreased.

Puncture of the brain with hematomas

As practice shows, today, in comparison with the past years, this procedure has few indications. In particular, the need for a puncture in order to detect intracerebral hematoma (in the absence of CT) has significantly decreased. In the opinion of individual experts, one should not perform a puncture for this purpose because the procedure promotes aggravation of damage, while hematomas are usually not detected.