US Patent 10448978 Spinal implant system and method

A surgical instrument comprises an outer sleeve including an inner surface that defines a cavity. An inner shaft is fixed with the outer sleeve and extending within the cavity. The inner shaft includes a drive engageable with a first mating surface of a bone fastener. An inner sleeve is disposed between the inner shaft and the outer sleeve. The inner sleeve is rotatable relative to the outer sleeve and includes an element connectable with a second mating surface of the bone fastener. Systems, spinal implants and methods are disclosed.