Embodiments of the present invention provide apparatus for guiding medical instruments, including a handle with a handle shaft, an alignment stand configured to interface with a receptacle of a cervical plate, an instrument guide tube coupled to the alignment stand and having a lumen therethrough, such that when the alignment stand is in communication with the receptacle, the instrument guide tube is positioned over a bone screw receiving hole in the cervical plate and an axial centerline of the instrument guide tube passes through the bone screw receiving hole. Instrument guide tube may swivel about the alignment stand via a rotational coupling, or may be one of two fixed instrument guide tubes. Alignment stand may include an angle-limiting post to interface with the receptacle to permit ranges of tilting, or a stem and optional bone pin for holding the alignment stand at a substantially constant angle in the receptacle.