A system for implanting an implant screw into one or more bones of a patient, such as the sacrum and the ilium, can include a rod and a screw. The screw can be generally hollow and have a blunt distal end. The rod can include a threaded and pointed distal end that is inserted through the rod to drive the screw through the bones. Once the screw is at a desired position, the rod can be removed such that the sharp driving edge used to seat the screw does not remain in the bone. The system can further include an extraction tool having a generally hollow body sized to be inserted over the rod and a distally located screw engagement portion configured to engage the screw to adjust positioning of the screw after it is initially seated.