Bone anchors and surgical instruments with integrated guide tips

A surgical method, comprising:

• advancing a bone anchor assembly through an incision in a patient, the bone anchor assembly being coupled to an inserter instrument having:
• an elongate body having a lumen, a distal end of the elongate body being configured to engage the bone anchor assembly;
• a stylus configured to be received in the lumen to translate in a proximal-distal direction relative to the elongate body;
• and
• a collar disposed around the elongate body, the collar being configured to allow translation of the stylus between a plurality of positions relative to the elongate body,
• wherein the stylus is axially translatable between at least a first position in which a distal end of the stylus protrudes from the distal end of the bone anchor assembly and a second position in which the distal end of the stylus does not protrude from the distal end of the bone anchor assembly;
• sliding the collar between (i) a locked position to rotate the stylus relative to the elongate body in a first direction to advance the stylus axially along a threaded surface of the elongate body and rotate the stylus in a second, opposite direction to retract the stylus axially along the threaded surface, and (ii) an unlocked position in which the stylus translates axially relative to the elongate body without being rotated relative to the elongate body, the collar being spaced from the stylus when sliding into each of the locked position and the unlocked position.

A system, comprising:

• a bone anchor assembly having a threaded shank;
• an elongate body having a lumen, a distal end of the elongate body being configured to engage the bone anchor assembly;
• a stylus configured to be received in the lumen to translate in a proximal-distal direction relative to the elongate body;
• and
• a collar disposed around the elongate body, the collar being configured to allow translation of the stylus between a plurality of positions relative to the elongate body, the collar being spaced from the stylus throughout the translation of the stylus between the plurality of positions;
• wherein the stylus is axially translatable between at least a first position in which a distal end of the stylus protrudes from the distal end of the bone anchor assembly and a second position in which the distal end of the stylus does not protrude from the distal end of the bone anchor assembly.