autologous graft material that is then used to form strut grafts between the same vertebrae 10 12 from which the grafts are formed note that in fig6 that flat surfaces 40 a 42 a of the segments are exposed to face one another across the intervertebral disc space 14 while the tool shaft 30 may be withdrawn with the cutting blade 24 from the disc space 14 at this time it is preferred that the shaft and the blade remain in place as noted below after removing a handle or other drive from the tool shaft 30 and as shown in fig7 to 9 an elongated pusher or paddle 50 is inserted into the disc space 14 until the paddle overlies the cutting blade 24 and extends substantially entirely over the exposed flat surfaces of the vertebral bone segments 40 42 in the disclosed embodiment the paddle 50 is formed at a distal end of a cannulated shaft 51 whose axial passage is keyed to the cross section of the tool shaft 30 the cannulated shaft 51 is slid over the tool shaft 30 a handle 52 is provided at the proximal end of the shaft 51 and the paddle 50 is inserted inside the disc space 14 using the handle 52 the paddle 50 is rotated together with the blade 24 if left in place through the same circular path initially cut by the blade 24 through the vertebrae 10 12 if the cage 33 is of such size that it encompasses.