The present invention provides spinous process implants and associated methods. In one aspect of the invention, the implant includes at least one extension with a first part and a second part where at least one arm is coupled to each of the first part and the second part. The first part and the second pan are movable from a compact to a distracted state. In another aspect, the present invention provides a second extension that is slidingly coupled to the first and second arms. The second extension further comprises a third part and a fourth part that move with the first and second part.
