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Completed

NCT Number: NCT06909292

Sacroiliac (SI) Joint Transfixing and Fusion: Meaningful Long Term Outcomes With Nevro1

The goal of this observational study is to learn if Nevro1 Sacroiliac Transfixing and Fusion System can treat sacroiliac joint dysfunction in males or females over 21. The main questions it aims to answer is what percentage of patients have clinically important pain relief with no adverse events, and what proportion of patients have fusion of the sacroiliac joint at 1 year and 2 years.

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Key information

Age range

21 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

AIRS Clinic, Lodi, California, United States

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Has medical insurance that covers this standard of care procedure and all other anticipated and unanticipated procedure-related care, and all coverage criteria required by insurer are met, which may include but are not limited to:
  • Has had low back and/or buttock pain for at least 6 months that is inadequately responsive to non-surgical care
  • Has a positive Fortin's test
  • Has a diagnosis of SIJ dysfunction (degenerative sacroiliitis or SI disruption) with pain elicited on at least 3 of 5 provocative tests (FABER, Gaenslen, Distraction, Thigh Thrust, Compression).
  • At least 75% reduction in pain for the expected duration of two anesthetics (on separate visits each with a different duration of action), and the ability to perform previously painful maneuvers, following an image-guided, contrast-enhanced intra-articular (diagnostic) SIJ injection
  • A trial of at least one therapeutic intra-articular SIJ injection (i.e. corticosteroid injection)
  • Has an ODI score ≥30% at enrollment
  • Has a SI joint pain score of at least 5 out of 10 on numerical rating scale at enrollment.
  • Be at least 21 years of age at enrollment
  • The patient's physician has decided that the best treatment for the patient's SIJ dysfunction is the Nevro1 SI Fixation System, and the patient has agreed to the treatment
  • Be willing and capable of giving written informed consent
  • Be mentally and physically able to comply with study-related requirements and procedures and attend all scheduled visits

Exclusion criteria

  • Has current severe back pain due to other causes, such as lumbar disc degeneration, lumbar disc herniation, lumbar spondylolisthesis, lumbar spinal stenosis, lumbar facet degeneration, lumbar radicular pain, and lumbar vertebral body fracture
  • Has SIJ pain secondary to inflammatory conditions or other known sacroiliac pathology such as: Sacral dysplasia, inflammatory sacroiliitis (e.g., ankylosing spondylitis or other HLA-associated spondylo-arthropathy), tumor, infection, acute fracture, and crystal arthropathy
  • Has had a previous SIJ implant placement, including an allograft
  • Has had an injection with corticosteroid into the index SIJ within the last 30 days
  • Has had a sacral radiofrequency ablation within the last 6 months
  • Has a history of recent (<1 year) major trauma to pelvis
  • Has previously diagnosed or suspected severe osteoporosis (defined as prior T-score < -2.5 or history of osteoporotic fracture)
  • Has a chronic rheumatologic condition (e.g., rheumatoid arthritis)
  • Has a known allergy to titanium or titanium alloys
  • Has a current local or systemic infection that raises the risk of surgery
  • Is currently receiving or seeking short- or long-term worker's compensation related to the SI joint or low back pain, is currently receiving disability remuneration related to SI joint or low back pain, and/or is currently involved in injury litigation related to the SI joint or low back pain
  • Is participating in an investigational study or has been involved in an investigational study within 3 months prior to enrollment
  • Has any condition or anatomy that makes treatment with the Nevro1 SI Fixation System infeasible
  • Is taking a medication known to have detrimental effects on bone quality and soft tissue healing
  • Has a prominent neurologic condition that would interfere with physical therapy
  • Be pregnant or plan on becoming pregnant in the next two years.
  • Has a medical condition or pain in other area(s), not intended to be treated in this study, that could interfere with study procedures, accurate pain reporting, and/or confound evaluation of study endpoints, as determined by the Investigator

Treatment and study plan

Sacroiliac Joint transfixing and fusion system (Nevro1)

Device

The Nevro1 is a titanium cage the is implanted in the sacroiliac join from a posterior direction, and then anchors are deployed that stabilize the joint. It has multiple openings to allow surgeons to fill them with autogenous bone graft to encourage bone bridging through the implant for SIJ fusion.

Primary outcomes

  1. Composite Pain Relief and Safety Responder

    Time frame: 6 months

    The proportion of patient meeting the following criteria:

    • NRS score for SIJ pain reduced by at least 2 points from baseline.
    • Absence of implant-related serious adverse events (SAEs).
    • Absence of neurologic worsening related to the lumbosacral nerve roots.
    • Absence of reoperation (removal, revision reoperation or supplemental fixation) for SIJ pain.

Secondary outcomes

  1. Change in Disability

    Time frame: 6 months

    Absolute change from baseline in Oswestry Disability Index (ODI) score. The total score ranges from 0 (minimal disability) to 100 (severe disability, e.g., bedridden).

  2. Patient Global Impression of Change (PGIC)

    Time frame: 6 months

    Proportion of patients reporting "Better" or "A great deal better" on the PGIC. The PGIC is a 7-point scale with responses ranging from "no change (or condition has gotten worse)" to "a great deal better".

  3. Physical and Mental Health Summary (PROMIS-29)

    Time frame: 6 months

    Absolute change from baseline in PROMIS-29 score. Higher scores represent greater impact of pain on a patients life in the domains of physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance.

  4. Change in Quality of Life

    Time frame: 6 months

    Absolute change from baseline in the index score of EuroQol 5-dimension 5 level (EQ-5D-5L) a standardized measure of health status. The index score ranges from zero to one, with one representing the highest possible health state.

  5. Change in Sleep Disturbance Due to Pain

    Time frame: 6 months

    Absolute change from baseline in Pain and Sleep Questionnaire Three-Item Index (PSQ-3) score. The scale ranges from 0 (pain does not affect sleep) to 30 (pain has maximum effect on sleep).

  6. Timed "Up and Go" Performance test (TUG)

    Time frame: 6 months

    Absolute change from baseline in time to perform the TUG.

Other outcomes

  1. Presence of bone apposition on implant surface

    Time frame: 12 and 24 months

    Grading of the presence of bone apposition on the device adjacent to the sacrum and ilium.

  2. Presence of bony fusion across the sacroiliac joint

    Time frame: 12 and 24 months

    Grading of the presence of bony fusion across the sacroiliac joint.

  3. Presence of radiolucency at the implant surface

    Time frame: 12 and 24 months

    Grading of the presence of radiolucency at the device surface adjacent to the sacrum and ilium.

  4. Proportion of patients with different levels of treatment response

    Time frame: 3, 6, 12, and 24 months

    Evaluating different pain relief response rates, defining responder as a participant who experiences ≥30%, ≥50% and ≥80% pain relief vs. Baseline as measured by NRS.

  5. Sub-analysis comparing outcomes between age groups

    Time frame: 3, 6, 12, and 24 months.

    All outcomes will be compared between the two age groups: 21 to 70 years, and 71 years and above.

  6. Rate of adverse events

    Time frame: Implant, 1, 3, 6, 12, and 24 months.

    Proportion of patients who experience and adverse event related to the procedure or device including infection, device breakage, migration, neurological worsening, and procedural blood loss.

Sponsors and collaborators

Lead sponsor

Nevro Corp

Industry

Registry information

Official study title

A Post-market, Multicenter, Prospective, Clinical Study to Evaluate the Nevro1 Sacroiliac (SI) Transfixing and Fusion System for the Treatment of Sacroiliac Joint Dysfunction

Acronym: SIMON1

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Apr 3, 2025
Registry last updated
Jun 25, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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