Bone marrow biopsies with a Silverman needle.

Advantages and disadvantages of bone marrow biopsies taken from the posterior iliac crest using the Silverman needle were evaluated. Sixty-three biopsies were carried out in patients on whom previous aspirations of the bone marrow space were unsuccessful. Open surgical biopsy was thus avoided in all but one case. Only local anesthesia was required. In 12 cases the first attempt to obtain material with the Silverman needle was unsuccessful.Limitations of the method are largely due to crushing of the specimen so obtained, with polarization of nuclei simulating the appearance of fibroblasts seen in cases of myelosclerosis. At times marrow was completely expressed from the spongy bone, leaving a useless specimen of spicules. The quality of histological material is usually inferior to that yielded by successful aspiration.Despite limitations, the Silverman needle method is considered to be preferable to open biopsy in cases in which attempts at aspiration have failed.