A patient specific operative guide (1) for use in spinal surgery, providing a stable coupling with the patient's vertebra, comprising at least one guiding member (2) for guiding a surgical operation on a patient's vertebra (100)； and a plurality of contact members (4, 5, 6) designed to match with a corresponding plurality of contact areas on the patient's vertebra in order to define a unique coupling configuration of the patient specific operative guide on the patient's vertebra, wherein said contact members (4, 5, 6) comprise a main contact member (4), designed to couple with a main contact area corresponding to the spinous process (101) of the patient's vertebra in said coupling configuration, and at least one pair of auxiliary contact members (5, 6), designed to abut on auxiliary contact areas, respectively positioned laterally left and laterally right of the spinous process, in said coupling configuration.
