An instrument for reducing a fixation rod within a screw extender that attaches to a spinal implant includes first, second, and third cannulated bodies and an inserter shaft. The first cannulated body includes a proximal end that couples with the screw extender. The second cannulated body rotates within the first cannulated body and includes a proximal end with a first driving feature and a distal end with an internal threaded portion. The third cannulated body includes a proximal end that engages the internal threaded portion and a distal end with a rod pusher for engaging the fixation rod. The inserter shaft rotates within the third cannulated body and includes a proximal end with a second driving feature and a distal end with a setscrew attachment feature.