The disclosure relates in certain embodiments to medical devices, systems and methods for use in osteoplasty procedures, such as vertebral compression fractures. One system for delivering a bone fill material to a bone includes an elongated introducer configured for insertion into a bone and having a channel sized to allow a flow of bone fill material therethrough. The introducer has at least one outlet opening in communication with the channel for delivering the bone fill material into the bone. A thermal energy emitter is coupled to the introducer and configured to apply thermal energy to the bone fill material flowing through the introducer. A sensor and a computer controller can be used to measure data about the bone fill material and to control certain aspects of the flow of bone fill material. A hydraulic pressure source may also be operatively coupled to the introducer and configured to apply a force on the bone fill material to provide a pressurized flow of bone fill material through the introducer. In certain embodiments, the system for use in osteoplasty procedures can include a cooling system that can be used to cool the bone fill material.