Buttermann GR - Long-term, >10-year clinical outcomes of anterior cervical discectomy and fusion (ACDF) were assessed herein. Also, on the basis of primary diagnosis of disc herniation, stenosis or advanced degenerative disc disease (DDD), number of levels treated, and preexisting adjacent level degeneration, outcomes were compared. For all primary diagnoses, ACDF afforded significantly improved outcomes and was sustained for >10 years’ follow-up. Additionally, secondary surgeries were performed for pseudarthrosis repair and symptomatic adjacent-level degeneration.