Torque multiplier, limiter, and counter-torque combinations and methods

A method of providing a torque multiplier, limiter, and counter-torque combination for use in spinal fixation surgery comprising:

• providing a drive train comprising a torque multiplier assembly and a torque limiter device, wherein an output of the torque multiplying assembly is drivingly coupled to an input of the torque limiter device;
• configuring an input of the drive train to be driven by a driver handle and an output of the drive train to rotate a driver;
• coupling a counter-torque connector that is configured to engage at least one member of a spinal fixation construct with a counter-torque handle to prevent rotation of the counter-torque connector and the spinal fixation construct;
• providing a coupling between a component of the torque multiplier assembly and the counter-torque handle to prevent a rotation of the component;
• configuring the driver handle and counter-torque handle to be simultaneously engaged by a single user, wherein torque input by the single user through the driving handle is simultaneously multiplied by the torque multiplier assembly and limited by the torque limiter device, while the single user simultaneously prevents the at least one member of the spinal fixation construct from rotating through the counter-torque handle.