Cement usually is used on its own in osteoporotic kyphotic corrections and mainly up to two levels. In more than that surgeons may assist the correction with intrumentation.
Usually posterior instrumentation is used for various spinal procedures. It involves use of titanium pedical screw and rod systems currently. In that past laminar wires or Hartshill rectangle implants etc .were used.
Cement use usually is not required in deformity surgery as it is used in osteoporotic vertebral compression fractures.