A method for distracting a pair of adjacent vertebrae and inserting an implant within the intervertebral space between the adjacent vertebrae using a posterior angle is described. The method employs a vertebral distractor-inserter comprising a housing, a pair of opposing arms in mechanical communication with the housing, a driving rod extending through at least a portion of the housing and between the arms, wherein the driving rod comprises an axis and a surface with a plurality of angled ratchet teeth on at least a portion of the surface, and a ratchet drive mechanism in mechanical communication with the driving rod.