Return of Bowel Function After One or Two Level Anterior Lumbar Interbody Fusion With Chewing Gum
Return of Bowel Function After One or Two Level Anterior Lumbar Interbody Fusion With Chewing Gum
Researchers are trying to identify is chewing gum improves bowel function after anterior
 lumbar interbody fusion
Aims, purpose, or objectives:

 1. Observe changes in bowel pattern based on gum-chewing

 2. Examine bowel function after anterior lumbar interbody fusion

 3. Measure length of time to return of bowel function after anterior lumbar interbody
 fusion

 4. Compare return of bowel function in patients who chew gum and patients standardized to
 usual post-operative care

 5. Measure the hospital length of stay amongst study groups

 6. Measure post-operative pain amongst study groups

 Background (Include relevant experience, gaps in current knowledge, preliminary data, etc.):

 One or two level anterior lumbar interbody fusions are designed to correct lumbar spondylosis
 and spondylolisthesis, which can cause debilitating back and leg pain. This surgery involves
 an anterior approach, which often requires displacement of bowel for the length of the
 surgery. Patients frequently have a slow return of bowel function secondary to anesthetic
 time, opioid use, and primarily due to the bowel displacement intraoperatively. Because this
 is a one or two level surgery, many patients would benefit from same-day discharge but often
 remain inpatient several days due to slow return of bowel function.

 Gum chewing has been shown to decrease the time for return to bowel function (RBF) in
 colorectal and gynecology patients postoperatively.

 Gum chewing and RBF has been studied in the spine population for posterior operations but not
 anterior spine surgery. This study aims to identify whether chewing gum has an impact on
 patient's report of pain, RBF, length of stay, and subjective report of satisfaction
 post-operatively. This could be an outpatient operation; however, pain and RBF often prevent
 patients from discharging home the same day of surgery.
Inclusion Criteria:

 1. Undergoing one or two level anterior lumbar interbody fusion

 2. Diagnosis of spondylosis, spondylolisthesis, revision of foraminal stenosis or
 neurogenic claudication

 Exclusion Criteria:

 1. Previous bowel surgery

 2. Diagnosis of an inflammatory bowel disease

 3. Allergy to xylitol

 4. Pregnancy

 Some participants may subsequently undergo a posterior spinal fusion on the same-day of
 surgery. They will not be excluded, but the investigators will include this group in a
 different data subset.