Apparatus, systems and methods for providing fixation to an interior body region of a patient are provided. The apparatus includes an expandable cage which is inserted into a body region, such as cancellous bone of a vertebra, in a first geometry, and transitioned to a second geometry. Delivery devices and other tools are included including a material delivery device used to inject an agent into a body region without requiring or creating a void in that region. Methods are also provided for providing fixation to an internal body region.