463 patients with degenerative cervical disc disease were randomized to operative management with either cervical disc arthroplasty (BRYAN artificial disc; Medtronic) or anterior cervical discectomy and fusion (ACDF) with allograft. Patients were followed for 10 years postoperatively. Only 235 patients - 130 and 105 patients in the groups, respectively - were available after 10 years. Available data demonstrated a non-statistically significant difference between groups in the rate of secondary surgery due to adjacent segment degeneration. However, composite endpoint for success, success rate for response on the Neck Disability Index, and cervical range of motion at 10 years all favoured the CDA group compared to the ACDF group.