An apparatus for inserting a medical implant (36), comprising a handle (12), an outer shaft (14) extending from the handle along a shaft axis (5), an inner control shaft (26) extending through the outer shaft along the shaft axis, an actuator (24) disposed with the handle, and pivotable connection means disposed on the outer shaft opposite the handle. The pivotable connection means includes an attachment screw (22) for engaging the implant, the attachment screw extending along a screw axis (7) through a window opening (20) in line with the outer shaft, the attachment screw being pivotable about a pivot axis transverse to the outer shaft, and the window opening being elongated so as to accommodate the pivoting of the attachment screw while the attachment screw extends through the window opening, the attachment screw) being operatively connected to the inner control shaft to permit rotational drive of the attachment screw through variable pivot angles between the screw axis and the shaft axis.
