We randomized 27 consecutive patients undergoing 1-level cervical disc surgery to surgery with or without anterior plate fixation. The patients were studied with radiostereometry and clinically with visual analogue scores (VAS) for arm and neck pain. After 2 years, 1 patient had developed pseudoarthrosis, all other fusions were healed, but 1 patient showed substantial motions in the fusion area between the 1- and 2-year follow-ups. The 12 patients operated on without a plate had increased rotations around the transverse axis, corresponding to deformation towards kyphosis. Clinically, there was no difference in outcome between the two groups, as assessed by VAS. The use of an anterior plate in 1-level degenerative disc surgery in the cervical spine seems to prevent rotational deformation, without affecting the clinical outcome or fusion healing.