Objective: To investigate and compare clinical and radiographic outcomes of patients with neck pain and cervical radiculopathy who underwent instrumented ACDF with or without foraminotomy by direct uncovertebral joint decompression.Methods: Retrospective clinical chart and radiographic review to assess clinical outcome and graft fusion in 50 patients (mean, 43 years;range, 27 to 71) who underwent one-or two-level ACDF with rigid anterior zero plate.21 patients who received one side or two sides direct uncovertebral joint decompression (Group A) were compared with 29 patients without direct decompression but indirect decompression by disc space distraction (Group B).