Demineralized Bone Matrix Bone Biology and Clinical Use

This article provides spinal surgeons with information regarding commercially available human demineralized bone matrix (DBM)-based products to aid in clinical decision making. As of April 2016, 51 commercially available DBM-based products were legally marketed for use in spinal fusion surgery with 29 peer-reviewed published studies reporting clinical data. Processing technique and carrier choice affect osteoinductive properties of DBM-based products, which vary drastically between different product formulations and even within different lots of the same product. This review supports the use of DBM-based products as graft extenders. Additional comparative studies are required to evaluate the efficacy of these products as stand-alone graft substitutes.