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.

 
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