Custom patient-specific interbody implants, systems, and methods of generating custom implants. The implants may include upper and lower surfaces with an irregular surface
topography, which are custom contoured to match the adjacent vertebral endplates of a specific patient. The method may include uploading images of the spine for the patient and
processing the images into a virtual three-dimensional model of the spine including
topography of individual vertebral bodies. The user may automatically and / or manually manipulate the virtual three-dimensional model to pre-operatively simulate a desired correction to the spine. The virtual
implant model may be generated based on the desired correction and the
topography of adjacent vertebral bodies.