A method includes percutaneously disposing an implant in a first configuration between adjacent spinous processes, the outermost surface of the implant being uniform and defining a first diameter in the first configuration, the implant being coupled to an expansion tool, moving a distal portion of the implant such that the implant is in a second configuration, the distal portion of the implant having a profile defining a second diameter when the implant is in its second configuration, and moving a proximal portion of the implant such that the implant is in a third configuration, the proximal portion of the implant having a profile defining a third diameter when the implant is in its third configuration, the second diameter and the third diameter being greater than the first diameter.