An apparatus for delivering bone cement into a vertebra includes a cannula and a mix and delivery device pivotally coupled to the cannula. The mix and deliver provides a single device in which a flowable compound may be mixed and the dispensed into the vertebrae through the cannula. The mix and delivery device includes a piston, slidably disposed within a barrel of the device, for advancing the bone cement through an outlet communicating with the cannula. An actuating device, which exerts a pressure, is connected to an inlet on the mix and delivery device (either directly or through a tube). The pressure created by the actuating device is used to advance the piston within the mix and delivery device.