Systems and methods for spinal fixation

1. A rod inserter tool for inserting a rod into a surgical site, the rod inserter tool comprising:

a handle;

a shaft coupled to the handle; and

a rack-and-pinion mechanism that comprises a first rod and a second rod, the rack-and-pinion mechanism configured to slide out of the shaft and to rotate the rod about an axis orthogonal to the shaft;

wherein the handle is rotatably coupled to the shaft and operatively connected to the rack-and-pinion mechanism wherein rotation of the handle actuates the rack-and-pinion mechanism so as to rotate the rod;

wherein the rack-and-pinion mechanism further includes a pivot pin, a head having ratchet teeth and a guide slot, and a guide rod disposed within the guide slot, wherein the second rod is slidably engaged with the pivot pin; and

wherein the second rod is slidably coupled to the head, and a distal end of the second rod is pivotably coupled to a proximal end of the rod.

2. The rod inserter tool as set forth in claim 1 , wherein the rack-and-pinion mechanism is disposed at a distal end of the shaft.

3. The rod inserter tool as set forth in claim 1 , wherein the first rod is fixedly mounted to the handle.

4. The rod inserter tool as set forth in claim 1 , wherein the rod includes ratchet teeth, and wherein the ratchet teeth of the head are configured to interact with the ratchet teeth of the rod.

5. The rod inserter tool as set forth in claim 1 , wherein the head is pivotably mounted to the shaft.