The present disclosure describes a device and methods for safely and accurately placing screws into bones with a powered driving device. By employing multiple 
layers of fail-safe features and image-guidance systems, the powered driving device provides safe, accurate, and efficient 
screw placement. That is, the powered driving device may continuously monitor a screw advancement and placement and may automatically shutdown when improper placement is detected. Monitoring placement may be conducted by a microcurrent-
monitoring system, by an image-
guidance system, or by any other appropriate 
sensory system. Additionally, upon detecting that screw 
insertion is complete, the powered driving device may be automatically shutdown. As 
screw placement is continuously simulated by image-guidance in real time, multiple redundant 
verification steps are eliminated, providing highly accurate 
screw placement while decreasing clinician error, device 
contamination, and surgical time, the decreased surgical time associated with decreased patient-
recovery time and associated medical costs.