One hundred and four patients with single-level cervical radiculopathy or mild myelopathy were randomized to receive either PEEK cages (n=52) or titanium-coated PEEK (TiPEEK) cages (n=52). The primary outcome of interest was fusion rates at one and two years postoperatively, assessed via radiological imaging. Secondary outcomes included pain scores for the neck and arm (using the Visual Analog Scale, VAS) and neurologic function (via NASS scores). Outcomes were monitored at 6 weeks, 6 months, 1 year, and 2 years. Overall, the study found no statistically significant differences in fusion rates between PEEK (86%) and TiPEEK (82%) at two years (p=0.59), nor in clinical outcomes. These findings suggest that titanium coating does not significantly enhance fusion or clinical outcomes in ACDF.