Aspects of present disclosures involve systems, methods, computer program products for creating a customized MIS spine guide using two-dimensional imaging. In particular, the present disclosure provides a method of creating customized implant or instrument trajectory guide using one or more two-dimensional (2D) images of the patient's vertebrae. The method for creating a customized MIS spine guide using two-dimensional imaging generally includes receiving a plurality of two-dimensional images of the patient's vertebrae from an imaging device, reformatting the two-dimensional images for surgical planning and creating a customized MIS spine guide from the 2D images, design a jig based at least on the placement of the mating shapes within the plurality of reformatted two-dimensional images by the computing device, and creating a customized spine guide using a milling machine or 3D printing device corresponding to the machine program.
