An interspinous process spacer is generally rectangular and may have an upper face that generally opposes a lower face, front and back sides that generally oppose each other, an end side, and a nose that generally opposes the end side. The spacer preferably has rounded edges between the upper face and the front, end, and back sides and between the lower face and the front, end, and back sides. The nose of the spacer is preferably asymmetrical and tapers integrally, distally, and inwardly from the first and second faces to form a generally pointed or rounded distal tip. A spacer may be inserted laterally into the interspinous space through a small, posterior midline incision, allowing the preservation of the supraspinous ligament. One or more spacers may be placed between spinous processes of adjacent vertebrae, and result in distraction of the spinous processes which may limit extension of the spine.