A surgical instrument includes a cannulated body extending along an axis and having a first working end spaced along the axis from a second working end. The surgical instrument may be used with a fenestrated screw assembly, a delivery unit, and an alignment guide wire. The first working end of the surgical instrument is configured to transmit a force to a delivery unit in a direction about the axis and the second working end is configured to transmit a force to a delivery unit in a direction generally transverse to the axis. The first working end may be used to rotate the delivery unit to thereby removably attach the delivery unit to the fenestrated screw assembly. The surgical instrument may be repositioned to engage the second working end with the proximal end of the delivery unit to maintain the rotational position of the delivery unit.