Reduction sleeve

Devices and methods for facilitating insertion of a spinal rod into a rod-receiving channel formed in a bone fixation element are described herein. In some embodiments, a reduction sleeve can include a through-bore sized to receive the bone fixation element and a transverse channel sized to receive the spinal rod and substantially aligned with the rod-receiving channel formed in the bone fixation element. The reduction sleeve can also include at least one break-off point for breaking and removal of the reduction sleeve The reduction sleeve can also include a plurality of threads for engaging a reduction instrument, an alignment mechanism so that the bone fixation element can only be inserted into the reduction sleeve when the rod-receiving channels are aligned, and an inwardly projecting protrusion formed on the inner surface of the reduction sleeve so that, once inserted, the projection contacts a top surface formed on the bone fixation element.