A bone cement mixing and delivery system for mixing separate components to form bone cement and for delivering the cement to a target site, said system comprising: a mixer including: a housing defining a mixing chamber for receiving bone cement-forming components, the housing having a discharge port; a paddle (126, 126', 126") rotatably disposed in the mixing chamber for mixing the components to form the bone cement; a mixing shaft connected to the paddle that rotates the paddle; a motor for rotating the mixing shaft so that rotation of the mixing shaft results in rotation of the paddle; and a piston having a face directed towards the housing mixing chamber, said piston being moveably mounted to said housing to transit through the mixing chamber to push the bone cement out through the housing discharge port; and a delivery device separate from the mixer housing, the delivery device including a reservoir that is connected to the housing discharge port for receiving the bone cement from the mixing chamber, characterized in that: said mixer includes a drive assembly (122, 152, 156, 160, 166, 167, 172, 192) that is connected to the motor for actuation by the motor and that is connected to both the mixing shaft and the piston, said drive assembly configured to, upon actuation of the motor, rotate the mixing shaft and move the piston through the mixing chamber. a mixer including: a housing defining a mixing chamber for receiving bone cement-forming components, the housing having a discharge port; a paddle (126, 126', 126") rotatably disposed in the mixing chamber for mixing the components to form the bone cement; a mixing shaft connected to the paddle that rotates the paddle; a motor for rotating the mixing shaft so that rotation of the mixing shaft results in rotation of the paddle; and a piston having a face directed towards the housing mixing chamber, said piston being moveably mounted to said housing to transit through the mixing chamber to push the bone cement out through the housing discharge port; and a housing defining a mixing chamber for receiving bone cement-forming components, the housing having a discharge port; a paddle (126, 126', 126") rotatably disposed in the mixing chamber for mixing the components to form the bone cement; a mixing shaft connected to the paddle that rotates the paddle; a motor for rotating the mixing shaft so that rotation of the mixing shaft results in rotation of the paddle; and a piston having a face directed towards the housing mixing chamber, said piston being moveably mounted to said housing to transit through the mixing chamber to push the bone cement out through the housing discharge port; and a delivery device separate from the mixer housing, the delivery device including a reservoir that is connected to the housing discharge port for receiving the bone cement from the mixing chamber, characterized in that: said mixer includes a drive assembly (122, 152, 156, 160, 166, 167, 172, 192) that is connected to the motor for actuation by the motor and that is connected to both the mixing shaft and the piston, said drive assembly configured to, upon actuation of the motor, rotate the mixing shaft and move the piston through the mixing chamber. said mixer includes a drive assembly (122, 152, 156, 160, 166, 167, 172, 192) that is connected to the motor for actuation by the motor and that is connected to both the mixing shaft and the piston, said drive assembly configured to, upon actuation of the motor, rotate the mixing shaft and move the piston through the mixing chamber.