A spinal fixation element is provided having a feature formed thereon that facilitates placement of the spinal fixation element through an access device, thus allowing the spinal fixation element to be positioned in relation to a spinal anchor that is coupled to the access device and that is implanted in a vertebra in a patient's spine. The feature also optionally facilitates placement of the spinal fixation element in relation to spinal anchors implanted in adjacent vertebrae. In particular, the spinal fixation element is adapted for use with an access device that has at least one slot or opening formed therein and having a width that is less than a width of the feature, thus preventing the feature from passing therethrough. The spinal fixation element can therefore be inserted through the access device, and a portion of the fixation element can be passed through the slot or opening in the access device while the feature is retained in the access device. As a result, the feature is seated within a spinal anchor that is coupled to the access device, and the remaining portion of the spinal fixation element can extend through the slot, preferably to be positioned within a spinal anchor disposed within an adjacent vertebra.