Table 3. Procedural Applications of Extracellular Matrix and Amniotic Derivatives in Bone and Nerve Repair.

AM: amniotic membrane; GBR: guided bone regeneration; ECM: extracellular matrix; FDA: Food and Drug Administration; dHACM: dehydrated amniotic membrane allograft

Application (Bone or Nerve)	Biologic Type (Source)	Status (Clinical or Preclinical)
Periodontal/Alveolar Bone Grafting - Guided bone regeneration in dental implants and periodontics [29]	Amniotic membrane allograft (placental AM) as GBR scaffold	Clinical (trials in patients)
Spinal Fusion - Enhancing arthrodesis in lumbar/cervical fusion surgery [46]	Amniotic fluid concentrate injection; amniotic membrane patch (amnion/chorion)	Clinical (pilot studies) + preclinical evidence
Long Bone Fracture Healing - Treatment of critical-size bone defects or non-unions [44]	Amniotic fluid or placental tissue (injectable ECM, stem cell-rich fluid)	Preclinical (animal models)
Peripheral Nerve Repair (Gap Bridging) - Repair of segmental nerve injuries in limbs [47,48]	Decellularized nerve ECM allograft (processed human nerve)	Clinical (FDA-approved allograft)
Peripheral Nerve Wrap - Adjunct cover for neurorrhaphy or nerve graft [49,50]	Amniotic membrane (amnion/chorion) sheet allograft	Clinical (case series/trial)
Spinal Cord Injury Repair - Scaffold for regenerating transected or damaged spinal cord [51]	Injectable ECM hydrogel (decellularized spinal cord or bladder matrix)	Preclinical (animal studies)
Dural Repair in Neurosurgery - Patch graft for dura mater after cranial or spinal surgery [52]	Dehydrated amniotic membrane allograft (dHACM)	Clinical (case reports)
Prevention of Epidural Adhesions - e.g., after laminectomy, discectomy, or tethered cord release [46]	Dual-layer amniotic membranes	Clinical (small clinical trials, case series, feasibility studies)