Multi-mode torque drivers employing inner surfaces compatible with pedicle screw guide wires, and related systems and methods are disclosed. A spinal column includes vertebrae in an articulating structure protecting a spinal cord. Medical intervention may involve limiting the relative motion between vertebrae by fusing vertebrae together with mechanical assemblies, including pedicle screws attached to the vertebrae. A multi-mode torque driver may be used to form the pedicle screw attachments with vertebrae. By including a passageway for a guide wire along an output rotational axis of a pedicle screw torque driver, pedicle screws may be inserted into a vertebra along a desired trajectory previously defined using the guide wire. In this manner, pedicle screws may be inserted into vertebrae precisely and efficiently.
