Background: ACDF is a standard procedure for cervical disc prolapse, addition of anterior plating is increasingly becoming a viable option for neurosurgeons especially in multiple level cervical disc prolapse.

Aim: Comparing between patients who complained of multiple level cervical disc prolapse who underwent ACDF without plates v with plates.

Patient and Methods: This clinical & radiographic retrospective study was performed on 20 patients with multiple level cervical disc prolapse. Half of these patients underwent ACDF without plates and the other Half underwent ACDF with anterior plating.

Results: Age if patients involved in this study ranged from 30 to 68 years old in both groups with a mean of 47 and 52 respectively. Regarding sex of patients, in the first group 5 were male and 5 were female while in the second group 7 were male and 3 were female. All complained of Neck Pain, 17 had Brachialgia and 3 with myelopathy.in the first group 9 patients had double level prolapse and one with triple level prolapse while in the second group 5 patients had double level and 5 had triple level disc prolapse. Regarding neck & arm pain, all patients showed significant improvement with no significant difference between two groups.

There were no major complications encountered.

Conclusions: Both procedures were comparable in achieving pain relief and functional improvement. Although the plate method was superior to the cage alone method in terms of fusion rate and reduced cage subsidence than that of cage alone, short-term outcome was almost the same.