the instrument consists according to fig1 of a shank 1 with a handle 2 arranged proximally on the shank , of a holder 3 for the implant , which is arranged on the distal end of the shank , and of an actuation rod 4 . the shank 1 is formed tubular and comprises at its distal end an annular surface 5 whose contour is shaped spherically ( see fig2 ), but may also be shaped conically . the shank 1 and the handle 2 are non - releasably connected to one another . in a channel 6 of the shank an actuation rod 4 is arranged in an axially displaceable manner . this is provided at its distal end with an insert 7 whose end - face region comprises a spherical recess 8 . on the proximal end of the actuation rod 4 there is seated a clamping head 9 with a threaded projection , which is screwed into a corresponding inner thread 11 on the proximal end of the handle 2 . thus , by rotating the clamping head 9 in a first direction , the actuation rod 4 with the insert 7 are moved distally , and by rotating the clamping head in another second direction , the rod 4 and insert 7 are moved proximally . at the distal - side end of the shank 1 there is mounted the holder 3 . this is provided with an essentially spherical bearing body 12 which , via a cylindrical extension 13 , blends into a distally tapering , conical , threaded spike , at whose foot there is provided an annular shoulder 15 as an abutment for the implant . the bearing body 12 is provided with a groove 16 which runs on a circular path of more than 180 °, into which engage pins 17 fastened on the shank 1 and lying on the same axis . for preparing the instrument for an operation the holder 3 is first assembled . the holder may for this purpose be designed as two parts and comprise a threaded projection between the bearing body 12 and the threaded spike 14 , to which these two parts may be releasably connected . the application of the holder 3 is then effected such that the bearing body 12 with the cylindrical extension 13 in front is first introduced into the channel 6 . then , the actuation rod 4 is pushed from the proximal end into the channel . by way of the mentioned threaded connection 10 / 11 of the insert 7 located at the end of the actuation rod 4 , and by rotating the clamping head 9 in the first direction , the rod 4 comes to take its bearing . thus , the bearing body 12 is clamped between the annular surface 5 and the recess 8 , so that subsequently the threaded spike 14 may be screwed to the bearing body 12 . the receiving , for example , of an implant 21 to be applied between two vertebral bodies 23 ( fig6 ) is effected such that the conical , threaded spike 14 is screwed into the implant up to its bearing on the annular shoulder 15 . thereafter , by proximal adjustment of the actuation rod 4 , the clamping force acting on the bearing body 12 may be reduced or lifted , so that the desired position of the holder and thus also of the implant relative to the instrument axis may be set . after fixing this position again by distal adjustment of the actuation rod 4 , the implant under endoscopic observation may now be brought to the location of the defect and applied . with this there exists the possibility of a correction of the previously set position within the context of a self - alignment , specifically by way of an intermediate release of the holder , and subsequent fixing of the holder as soon as this has automatically aligned into a position suitable for the application procedure . in order , for example , to connect and bridge neighboring vertebral bodies by way of a bone plate 24 , according to fig7 which is to be screwed to these bodies , instead of the threaded spike 14 there is applied a holder 3 with a screwdriver tip 20 , so that the instrument in total as a screwdriver , with the screws 22 as implant parts , may be screwed through the bone plate 24 into the respective vertebral bodies 23 . it will be appreciated by those skilled in the art that changes could be made to the embodiments described above without departing from the broad inventive concept thereof . it is understood , therefore , that this invention is not limited to the particular embodiments disclosed , but it is intended to cover modifications within the spirit and scope of the present invention as defined by the appended claims .
the instrument serves for the application in particular of bone grafts in the space between two vertebrae and includes a shank , a handle , and a holder for the implant , which forms the distal instrument part . the holder is pivotably mounted relative to the shank and can be fixed in any respective position which is reached by pivoting .