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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


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



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



Cascade IOMAX


Group Chat Yes Yes
User Roles & Preferences Yes Yes
Connected Users Yes Yes
Audit Log Yes Yes



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


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



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?

c2 carts for cascade iomax and pro

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 logo

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.

logo for cadx surgical simulator

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.

image for IONM Workshop

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.

STS-65 Launch

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.

The crew of the space shuttle

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 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.

Purchase IONM electrodes at the Cadwell estore

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.

Purchase IONM probes at the Cadwell estore

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.

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.