One hundred thirty-six patients with single-level cervical radiculopathy were randomized to receive either arthroplasty (n=68) or anterior cervical discectomy and fusion (n=68). The primary outcome was change in Neck Disability Index (NDI) score. Secondary outcomes included arm pain, neck pain, quality of life (EQ-5D), reoperation rates, and incidence of adjacent segment disease. Outcomes were assessed up to 5 years postoperatively. Overall, the results of the study revealed no significant difference between the two groups in change in NDI scores at 5 years, with both groups experiencing substantial and sustained improvements. These findings suggest that arthroplasty and fusion are equally effective surgical options for managing single-level cervical radiculopathy over the long term.