Abstract: Multi-mode torque drivers employing anti-backdrive units for managing pedicle screw attachments with vertebrae, 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 torque driver may be used to form the pedicle screw attachments with vertebrae. By including an anti-backdrive unit and a motor assembly enclosed within a handle body as part of a multi-mode torque driver, the user may apply sequential combinations of manual and motorized torques to the screws with high levels of tactile feedback as desired. In this manner, pedicle screw attachments may be efficiently achieved with fewer injuries to the patient and surgeon while minimizing screw attachment failures.