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Intraoperative Neuromonitoring Solutions
Surgeries are inherently risky, especially those that involve the brain, spinal cord or nerves. Intraoperative neurophysiological monitoring (IONM) is performed during many different types of surgeries to reduce the risk of devastating, irreversible neurological deficits, such as muscle weakness, loss of sensation, hearing loss, and impairment of essential bodily functions.
IONM involves multi-modal recording of electrical potentials from the nervous system during operations to detect adverse changes, enable corrective action, and offer surgical guidance.
Cadwell gives you the choice between pod and module-based IONM systems
Both Cascade IOMAX and Cascade PRO are scalable for hospitals and service providers. Cadwell is one of the only companies that routinely allows customers to purchase or provide their own PC if they prefer to purchase their own.
The pod-based Cascade PRO IONM system is the device of choice for many monitoring hospitals and service providers.
The Cascade PRO can be customized for 16 or 32 channels with external amplifiers. Extender pod shielding reduces noise and provides surge protection. PRO can be portable or cart based, and supports the TCS-4 and TCS-1000 transcranial stimulators and the ES-IX 2 electrical stimulator.
Cascade IOMAX is a rugged, module-based IONM system. This robust and flexible solution is ideal for hospitals and services using a minimum of three modules, a higher channel count, interchangeable cables, and new extension pods for the Cortical Module.
IOMAX is designed for long-term durability: it is drop-tested and water-resistant.
See why you should choose Cadwell’s Cascade IONM/IOM Solutions
Cadwell IONM solutions are time-tested over two decades of innovation, experience, and investment.
Watch the video to learn the value you can expect from our IONM/IOM components, consumables, and carts.
Cascade IONM Family Feature Comparison Chart
Modes
Cascade IOMAX |
Cascade PRO |
|
| Common Modes | SSEP, EMG, TEMG, MEP, EEG, DWave, BAEP, VEP, Video | |
| Automatic Threshold | Yes | Yes |
| Direct Cortical Stimulation | Yes | No |
| SpO2 | Up to 4 | No |
Tools
Cascade IOMAX |
Cascade PRO |
|
| CadCapture | Yes | Yes |
| Diagnostics | Yes | Yes |
| CadLink Server | Yes | Yes |
| Switch User | Yes | Yes |
| Comprehensive Data Export | Yes | Yes |
| Impedance | Amplifier Inputs and Stimulator Outputs | Amplifier Inputs |
| TCS Montaging | Software-Driven | Hardware-Driven |
| CadX Simulator | Yes | Yes |
Procedure Setup
Cascade IOMAX |
Cascade PRO |
|
| Mode Import/Export | Yes | Yes |
| MS Word Reports | Yes | Yes |
| Mode Groups | Yes | Yes |
Administration
Cascade IOMAX |
CASCADE PRO |
|
| Group Chat | Yes | Yes |
| User Roles & Preferences | Yes | Yes |
| Connected Users | Yes | Yes |
| Audit Log | Yes | Yes |
Specifications
Cascade IOMAX |
Cascade PRO |
|
| Platform | Module-based with optional extender pods | Pod-based |
| Channels | Up to 80 | 16 or 32 |
| Water Ingress | Waterproof and Drip-proof | Drip-proof |
| Drop-Tested | All components | Some components |
| Cables | Single cable type | Three cable types |
| Auditory | Insert Earphones | Insert Earphones or Headphones |
| Visual | Goggles with Disposable Foam | Goggles |
| PC Interface | USB | 10BaseT |
| ESU Detection | Software Integrated with sensitivity adjustment | Detection Clip |
| Case | Hard-sided | Hard-sided or Soft-sided |
Transcranial
Cascade IOMAX |
Cascade PRO |
|
| Intensity | Up to 1000 V / 1500 mA | Up to 1000 V / 1000 mA |
| Pulse Width | 50-500 uS with automatically reduced intensity | 50, 75 uS |
| Pulses | 9 | 9 |
| Mode | Constant Current or Constant Voltage | Constant Voltage |
| Double Train | Yes | Yes |
| Facilitation | Yes | Yes |
| Outputs | Nine Independently Configurable Outputs as Anode or Cathode |
One or Four Fixed Pairs |
| Biphasic | Yes | No |
EStim
Cascade IOMAX |
Cascade PRO |
|
| Intensity | 100 mA / 400 V | 100 mA / 400 V |
| Mode | Constant Current | Constant Current or Constant Voltage |
| Outputs | Up to 20 | Up to 16 |
Low Current
Cascade IOMAX |
Cascade PRO |
|
| Intensity | Up to 20 mA | Up to 20 mA |
| Step Resolution | 0.01 up to 20 mA | 0.01 up to 5 mA then 0.1 steps |
| Operating Mode | Constant Current | Constant Current or Voltage |
| LCSwap | 12 outputs selectable as anode or cathode and 2 output pairs for probe connections | No |
Cadwell Solution Guides for IONM
Cadwell’s Solution Guides are designed to give you a comprehensive understanding of the hardware, carts, supplies, accessories, and electrodes that Cadwell offers to support Cascade IOMAX and Cascade PRO IONM systems.
We understand the importance of cart design. We develop and innovate our IONM carts to delight technologists.
- Ideal for the OR
- Ergonomic design with adjustable heights for sitting and standing
- Surgeon-view swivel monitors
- Single or dual monitor mounts
- Telescopic camera poles
- Additional storage for IONM electrodes and accessories
- …and much, much more!
Need help configuring the perfect cart for your practice?
Cascade Surgical Studio software is easy to learn and use
Cascade Surgical Studio (CSS) is the latest generation of Cascade IONM software, and builds on the foundation of our Cascade Classic software application.
The intuitive CSS user interface allows you to streamline your workflow, deliver clinical excellence, capture critical information, strengthen documentation, and share and manage resources. All-modality monitoring, dynamic montaging, auto-capturing event screenshots, viewing live and saved data side-by-side, and remote monitoring with independent display and reporting are just some of the features that make CSS the ideal tool for surgical monitoring.
Cascade Surgical Studio enables rapid detection of nervous system compromise, and efficient sharing of information between IONM monitoring team, the anesthesiologist, and the surgeons.
CadLink Data Management software helps you manage and access information when and where you need it
For secure and efficient access to clinical information across multiple computers when and where you need it, we have CadLink Data Management. This system helps deliver efficient workflows, quality data, and easy reporting. It stores patient records and reports, manages user access, and can support HL7 interfacing and automatic archiving.
CadLink also supports remote IONM monitoring
CadLink Server supports Remote Monitoring. The connection mechanism requires the Remote Reviewer to be connected to the Server, open the Surgical Studio application, navigate to the Review Cases screen and then select a case to open. Multiple cases can be reviewed using the same instance of Surgical Studio software.
CadX Surgical Simulator lets you learn and practice outside of the OR
Many major teaching hospitals use Cascade IONM/IOM, and now CadX Simulator, to train current and future generations of Intraoperative Neuromonitorists, Surgeons, and Physicians. CadX lets you manipulate the patient control panel to replicate real-world scenarios for demonstration and assessment purposes, including anesthesia effects, technical setup errors, physiological and non-physiological trace characteristics, and pedicle screw stimulations. For the first time, you can experience and practice IONM outside of the operating room.
Ask your Cadwell sales representative or distributor for a reference list of hospital systems using CadX Simulator.
We offer and support valuable IONM education opportunities
Cadwell’s Education site features regular in-person and virtual workshops for continuing education and ASET CEU credits. Comprehensive IONM workshops allow anyone in the world to benefit from this valuable education. See our Workshops page for the latest information and schedule of course offerings.
Cadwell’s Support site offers instructional videos on Cascade Surgical Studio (CSS), including how to save time in procedure setup, tools for quality management, timeline enhancements, and user workflow enhancements. Recorded webinars provide a deeper dive into CSS.
CadCare customer support is unmatched in the neuro world
Our CadCare Customer Support Programs give you additional options including extended service plans, CadLink Software Support and Maintenance Program to help protect you and your investment. With the purchase of each IONM system from Cadwell, you acquire a lifetime CadCare membership, a limited factory warranty, and limited Software Maintenance Support.
We have history… and a future
Cadwell Industries, Inc. has been delivering innovative neurophysiological solutions since 1979. Cadwell is family owned and operated, and is solely dedicated to neurophysiology. Our mission is helping you help others, and we honor this by enabling our customers to help patients by creating superior solutions and medical devices. Our customers, their patients, and our team members are our stakeholders.
Cadwell developed EMG machines throughout 1980s and 1990s that were used for intraoperative monitoring and evoked potentials, including the CTS5000, the 8400A, the Spectrum 32, the Quantum 84, the MES10, and the Excel.
Cadwell released the Cascade 16-Channel in 2001 as a dedicated intraoperative neuromonitoring (IONM/IOM) system, Since then, Cadwell has developed and supported four generations of Cascade systems: the original Cascade 16, Cascade Elite, Cascade PRO, and Cascade IOMAX.
Did you know?…
In July, 1994, Cadwell sent a modified Quantum 84 into space on the Space Shuttle Columbia as part of the Second International Microgravity Laboratory. It was the only piece of medical equipment on the mission that worked, and scientists all over the world studied data collected on the Cadwell machine.
We listen to our customers
For the past two decades, we have listened to our IONM customers’ needs and invested in responsive research and development. Our dedication to neurophysiology leads to ongoing product enhancements, and new product introductions, to drive growth across the depth and breadth of the surgical monitoring community. Our regular software updates include feature requests and workflow improvements suggested by our customers.
Shop our estore for a complete line of IONM electrodes, accessories, and consumables
Cadwell offers a complete line of IONM electrodes, lead wires, probes and stimulators at www.estore.cadwell.com. We continuously innovate and release new consumables that our customers need and use. Check out our Supplies and Accessories Product Catalog.
International Customers: Some products may not be available in all countries and markets; check availability with your Cadwell distributor.
IONM Electrodes
Shop Cadwell’s e-store for a large selection of high quality needles that meet all of your IONM subdermal needle needs, including cork screw, parallel paired, bent, twisted, singles, and ENT needles.
IONM Probes
Cadwell offers a vast disposable probe portfolio for IONM and stimulating for a variety of procedures, including monopolar, concentric, bi-polar, bent, and flush tip stimulating probes.
Specialty IONM Supplies
Cadwell offers a suite of IONM specialty electrodes, including endotracheal tubes, laryngeal surface electrodes, subdural strips, epidural spinal electrodes, Cadwell Clip-On Plungers and our patented Multi-Stage Clip.
Download flyers, get software updates, and request IONM hardware and software features
Find all the IONM electrodes and accessories you need at www.estore.cadwell.com
Explore Cascade IONM products
Schedule your Cascade Surgical Studio demonstration
Product availability may vary between different countries and markets. Please contact Cadwell for additional information.