65 patients were randomized to compare the functional and radiographic outcomes of fusion and Bryan cervical disc replacement for the treatment of two level cervical disc disease. Patients were randomized to undergo either two-level arthroplasty with the Bryan cervical disc prosthesis or two-level anterior cervical discectomy and fusion (ACDF) with iliac crest autograft and plate. The results from a 2 year follow-up demonstrated that both groups produced a significant reduction in the neck disabilities index (NDI) and arm pain; although, the Bryan cervical disc provided a greater percentage improvement in NDI. These findings indicated that the Bryan cervical disc prosthesis is a safe and reliable alternative treatment to ACDF in patients with two level cervical disc disease.