Of all the stem cell procedures performed, bone marrow aspirations have the most history. They have been successfully performed for many years. There is no doubt that this is an extremely safe procedure. The techniques for performing bone marrow aspirations have not changed much over the years. The difference makers have been surgical and centrifugation techniques.
There are many companies out there that produce PRP centrifugation kits but the number of companies that produce bone marrow aspiration kits drops dramatically. One of the reasons for this is the difficulty in adequately separating the bone marrow into its component parts. Much attention has been placed into this technology of separating the marrow into its component parts. The needle we have been using all these years is called a Jamshidi type needle. There are other similar type needles out there.
In a nutshell the Jamshidi type needle has a hollow center and the fluid is withdrawn from the bottom and side holes (the bottom hole is much larger the side holes). One important fact to keep in mind when performing a bone marrow aspirate is after you aspirate a few CCs of marrow fluid you are no longer getting marrow aspirate but whole blood. The whole blood fills the marrow cavity in the area where the surgeon is aspirating. The number of stem cells goes down dramatically when you are aspirating from that portion of the marrow cavity that has now filled mainly with whole blood.
First is the fact that the bottom of the needle is closed. This eliminates a problem arising from one of the principles of physics. This principle is that fluids will follow the path of least resistance. Thus with the older types of needle most of the marrow aspirate would be sucked thru the large bottom opening with very little aspirate coming thru the side holes. Remember after a few CCs we are aspirating whole blood not bone marrow aspirate. This is contrary to what we want. The more aspirate coming thru the side holes the higher the cell counts and the lower the amount of whole blood aspirated. The reason for this is we are taking sampling from different areas. However, if we leave the needle is the same position we would still be aspirating large amounts of whole blood.
The second intriguing aspect of this new needle is the fact the needle has the ability to be advanced one centimeter at a time. This is done by a rotating mechanism. This is significant in that we can now sample different areas without making different punctures. Normally, we would take about 60 CCs of bone marrow. From this 60CCs we would obtain after processing about 10CCs of finished product. With this new technique we would possibly need only 8-10 CCs of marrow aspirate.