Telescoping interspinous fixation device and methods of use

An apparatus comprising:

• a first extension having a lateral facing side and a medial facing side, the medial facing side adapted to reside proximate a first surface of a spinous process, the first extension defines a horizontal axis that extends substantially perpendicular to the medial facing side;
• the first extension including a first part comprising a first male member extending in an inferior direction along a first vertical axis and a first female member extending in a superior direction along a second vertical axis, the first female member defining a first socket;
• the first extension including a second part comprising a second male member extending in a superior direction along a third vertical axis and a second female member extending in an inferior direction along a fourth vertical axis, the second female member defining a second socket, wherein the third vertical axis is substantially aligned with the second vertical axis such that the second male member is telescopically received in the first socket and the fourth vertical axis is substantially aligned with the first vertical axis such that the first male member is telescopically received in the second socket;
• a plurality of arms cantilevered from the medial facing side of the first extension and extending a distance along the horizontal axis, the plurality of arms including a first arm that has a plurality of one-way ratcheting teeth;
• and
• the first and second male members and the first and second female members of the first extension permitting movement between a compact state where the first and second parts are disposed adjacent to one another and a distracted state where the first and second parts are spaced apart from one another;
• a second extension comprising a lateral facing side and a medial facing side, the medial facing side adapted to reside proximate a second surface of the spinous process opposite the first surface;
• the second extension including a third part and a fourth part that are movable with the first part and the second part from the compact state to the distracted state, the second extension defining a first interior cavity sized to slidingly receive the first arm;
• and
• a plurality of corresponding one-way ratcheting teeth disposed in the first interior cavity of the second extension that engage the plurality of one-way ratcheting teeth of the first arm and permit incremental movement of the second extension along the horizontal axis in only one direction toward the first extension, wherein the second extension includes a port in communication with the first interior cavity, the port receiving a movable plunger that defines the plurality of corresponding one-way ratcheting teeth wherein the plunger is movable from a first position where the plurality of corresponding one-way ratcheting teeth of the plunger engage the plurality of one-way ratcheting teeth of the first arm to a second position where the plurality of corresponding one-way ratcheting teeth of the plunger disengage the plurality of one-way ratcheting teeth of the first arm.