The devices and methods described involve driving a working tool in an axial direction such that linear movement is controlled and measurable and injury to structures surrounding a bone to be drilled can be avoided. A medical drilling device (200) comprises a housing (210) comprising a proximal end of the housing and a distal end, an axial drive shaft extending through a region of the housing between the proximal and distal ends and engaged with an axial drive motor (230), a rotational drive shaft extending through a region of the housing between the proximal and distal ends and engaged with a rotational drive motor (260) configured to rotate the rotational drive shaft around a longitudinal axis of the rotational drive shaft, a coupler (290) configured to rotate with the rotational drive shaft around the longitudinal axis of the rotational drive shaft and removably couple with a working tool (310), a drill guide assembly coupled to the axial drive shaft and comprising a drill guide (370) configured to receive the working tool (310) therethrough, a transducer interfaced to the axial drive shaft and an electronics package in electronic communication with the transducer. The electronics package is configured to control actuation of the axial drive motor to cause the axial drive shaft to drive the drill guide assembly in an axial direction towards the proximal end of the housing thereby revealing a portion of the working tool (310) beyond a distal end of the drill guide available to engage a target tissue. The axial drive shaft is axially aligned with the longitudinal axis of the rotational drive shaft.
