A method of determining the size and/or placement of screws or other
instruments in pedicles during surgery in a selected spinal area,
comprising generating a dimensionally true three-dimensional image of the
bony spine in the selected spinal area; hollowing out the vertebra in the
three-dimensional image with cortical wall thicknesses selected by a
surgeon performing the surgery; determining the narrowest cross section
(isthmus) within each pedicle; generating a straight line starting at the
center of the isthmus and extending inwardly to a point centered within
the anterior cortex so that it is positioned concentrically within the
pedicle without touching the walls thereof, the line terminating inside
the vertebral body a predetermined distance from the anterior inner
cortical wall and extending outwardly in the opposite direction to
penetrate the posterior pedicle cortex; expanding the line concentrically
and radially to a cross sectional size that is less than that of the
isthmus, the line being expanded into a cylinder that stops growing when
any portion thereof contacts the inner cortical wall of the hollowed out
vertebral body, with the exception of the posterior pedicle cortex; and
calculating the ideal pedicle screw or instrument diameter, length and/or
trajectory based on the dimensions and trajectory of the cylinder
generated for each pedicle. Also, a new and improved method for providing
access to the interior of a pedicle for a desired transpedicular
procedure, and a new and improved pedicle cannula construction are
disclosed herein.