Researchers conducted a retrospective cohort analysis. For a study, they sought to compare the clinical outcomes of cervical disc replacement (CDR) vs anterior cervical discectomy and fusion in patients with severe cervical spondylosis (ACDF). As measured by a validated grading system, patients with substantial cervical spondylosis who underwent 1-level or 2-level CDR or ACDF were identified, and prospectively collected data were retrospectively evaluated. Researchers looked into the following patient-reported outcomes (PROs): PROMIS Physical Function (PROMIS-PF) Computer Adaptive Test Score, Neck Disability Index (NDI), visual analog scale-Neck, visual analog scale-Arm, and PROMIS Physical Function (PROMIS-PF) Computer Adaptive Test Score The 2 groups were compared on demographic, surgical, and radiographic characteristics, as well as the accomplishment of the minimum clinically meaningful difference (MCID) for each PRO. The current study comprised 66 patients, 35 treated with CDR (53%) and 31 with ACDF (47%), respectively. The 2 groups had similar preoperative cervical spondylotic grades (1.8 vs 2.2, P=0.27). There was no significant difference in the absolute value for each PRO between the 2 groups at the final follow-up (P>0.19), and both groups showed substantial improvement in each PRO compared to preoperative values (P<0.01). When comparing CDR to ACDF, there was no significant difference in the percentage of patients achieving the MCID for each PRO (P>0.09). When treated with CDR or ACDF, a similar percentage of patients with severe degenerative cervical spondylosis reached the MCID across multiple PROs. Compared with preoperative levels, patients in both therapy groups showed significant improvement in all PROs.