The insertion tool and pusher system of the present invention includes a bone screw having a head and a shaft. An annular washer is adapted to be mounted on the bone screw shaft. An insertion tool having a longitudinally extending shaft with an axial bore therethrough is provided for receiving the bone screw. The shaft has a first end with a washer retention surface surrounding the insertion tool cannulated shaft bore. The washer is held on the retention surface which positions the washer to receive the bone screw shaft. Pin-like spring elements are used to hold the washer in position. A plate is mounted on an outer surface at the first end of the inserter shaft, the plate having a bone contacting surface.
