Anterior cervical decompression and fusion procedure using stand alone peek cages is established as a safe and efficient procedure in treatment of cervical spondylosis with no central canal congenital narrowing. Proper decompression of neural elements can be usually achieved successfully with good fusion rates and outcomes. Literature reports good outcomes and high fusion rates within the 90th percentiles manifested mainly in one level decompression and fusion. Still multiple level decompression and fusion offers more challenges with a higher rate of complications and lesser fusion rates with an average pseudoarthrosis rates ranging from 4-10%. In our series, 40 patients with cervical spondylosis with various symptoms were enrolled prospectively for treatment using anterior cervical approach, neural decompression and fusion using carbon peek cages versus anterior cervical plate and graft.