Abstract:[Objective] To compare of clinical consequences of anterior cervical discetomy and fusion (ACDF) versus anterior cervicalcorpectomy and fusion (ACCF) for multi-segment cervical spondylotic myelopathy (MCSM). [Methods] A retrospective study was conductedon 102 patients who had MCSM treated surgically in our hospital. According to the results of doctor-patient communication, 51 patients re-ceived ACDF, while the other 51 received ACCF. The perioperative, follow-up and imaging data of the two groups were compared. [Results]The ACDF group proved significantly superior to the ACCF group in terms of operative time [(125.8±12.6) min vs (136.8±13.7) min, P＜0.001], intraoperative blood loss [(185.6±18.6) mL vs (206.7±21.2) mL, P＜0.001] and hospital stay [(10.6±1.1) days vs (12.7±1.3) days, P＜0.001]. With time went on, the NDI and JOA scores, as well as pyramidal tract sign significantly improved in both groups (P＜0.05). However,the ACDF group proved significantly better than the ACCF group regarding JOA score 6 months after surgery and at the last follow-up[(13.6±1.6) vs (12.1±1.3), P＜0.001; (15.1±1.6) vs (14.4±1.6), P=0.029], and NID score at the latest follow-up [(10.8±1.1) vs (13.6±1.3), P＜0.001]. As for imaging, the cervical lordotic angle, C2~7 sagittal vertical axis (SVA), T1 slope and minimum sagittal diameter of spinal canalsignificantly improved in both groups at the last follow-up compared with those preoperatively (P＜0.05). The ACDF group was also significant-ly better than the ACCF group in terms of cervical lordotic angle [(28.8±2.9)° vs (5.1±2.5)°, P＜0.001], SVA [(11.4±1.2) mm vs (15.4±1.6) mm,P＜0.001] and T1 slope [(25.1±2.5)° vs (28.3±2.9)°, P＜0.001]. [Conclusion] The ACDF does effectively reduce surgical trauma and achievebetter clinical outcomes for MCSM over the ACCF.