Systems, procedures and tools for repairing, or reinforcing the spinous process. The systems and procedures provide for injecting bone cement into and optionally around the spinous process. Additional reinforcing elements may be embedded in the bone cement inside or outside the spinous process. The procedures include positioning of the guide and reinforcing elements relative to a spinous process, preparation of the spinous process for injection and injection of bone cement into the spinous process. Tools are provided to facilitate the accurate injection of bone cement. The systems and procedures increase the strength of the spinous process and enhance the applicability and outcome of spinal interventions.