The present invention discloses spinous process fixation devices, systems, and instruments. The spinous process fixation device includes a first member, a second member, a third member, and a fourth member. Each of the first and second members includes a body and an engagement member and the engagement member of the first member couples to the engagement portion of the second member. Each of the third and fourth members also includes a body and an engagement member and the engagement member of the third member couples to the engagement portion of the fourth member. A method of assembling the spinous process fixation device and methods of using the spinous process fixation devices are also disclosed. A reamer instrument is also disclosed.
