Harmonizing diversity: introducing a universal classification system and database concept for anatomical variations

Year 2025, Volume: 19 Issue: 3, 101 - 108, 15.01.2026

Sachintha Buddhika Sampath , Deepan Jayapala , Prasan Warnakula , Akhila Wimalasundera , Ruchira Muhandiram , Uthpala Neththikumara , Oshadi Jayasena , Dinushi Jinadasa

Abstract

Objectives: Despite the wide interest in studying anatomical variations of the human body, significant gaps and inconsistencies remain in the literature. The use of variable terminologies and inconsistent classification systems remain a few of the key contributors for this gap. Many of these challenges can be addressed by adopting a universal classification system alongside a standard database. This study introduces a practical approach for the classification of variations that can reduce miscommunications and ensure a thorough evaluation.
Methods: In this novel Universal Classification System, solid organ variations are categorized as variations in: measurements (size, weight, dimensions); shape; consistency (presence, absence, multiplication); variation in associated structures or ducts (origin, termination, branching, variation in supply and consistency); and variations in blood supply, lymph drainage and innervation. For nerves, lymph and blood vessels, variations are classified as variation in origin (level and mode of origin – normal or aberrant); variation in termination (level and way of termination as bifurcation, trifurcation, etc.); branching variations (origin, variation in supply and consistency); consistency; and site of supply. An additional category of ‘other’ includes variations that cannot be classified under the above categories (aplasia/absence, hypoplasia, fenestration, tortuosity, loops, etc.).
Results: Application of the proposed Universal Classification System demonstrated that anatomical variations can be systematically and consistently categorized across different organ systems. Based on these findings, a standardized database model was developed to store and manage variation data using the same classification framework. The results define the database structure, data entry and storage procedures, maintenance principles, and access protocols, providing a practical and reproducible tool for the standardized documentation and retrieval of anatomical variation data.
Conclusion: The findings of this study confirm that a universal classification system can effectively standardize the evaluation of anatomical variations. The resulting database framework translates this system into a practical and scalable tool, facilitating consistent reporting, data storage, and knowledge transfer. This approach contributes to a more coherent and accessible body of anatomical variation data for educational and clinical use.

Keywords

anatomical variations , database , universal classification system

References

• J.R. Sañudo, R. Vázquez, J. Puerta. Meaning and clinical interest of the anatomical variations in the 21st century. European Journal of Anatomy 2003;7:S1–3.
• Burley HEK, Haładaj R, Olewnik Ł, Georgiev GP, Iwanaga J, Tubbs RS. The clinical anatomy of variations of the pectoralis minor. Surg Radiol Anat 2021;43:645–51.
• Bruneder S, Wallner J, Weiglein A, Kmečová Ĺ, Egger J, Pilsl U, Zemann W. Anatomy of the Le Fort I segment: are arterial variations a potential risk factor for avascular bone necrosis in Le Fort I osteotomies? J Craniomaxillofac Surg 2018;46:1285–95.
• Baktiroglu S, Yanar F, Yuksel S, Celik B, Kilic HG. Elbow AVF configurations and indications. J Vasc Access 2017;18:S98–103.
• Willan PL, Humpherson JR. Concepts of variation and normality in morphology: important issues at risk of neglect in modern undergraduate medical courses. Clin Anat 1999;12:186–90.
• Suhani S, Shree A, Kumar N, Rao L. Supernumerary heads of biceps brachii muscle in South Indian cadavers. Anatomy Journal of Africa 2013;2:108–13.
• Hong JT, Lee SW, Son BC, Sung JH, Yang SH, Kim IS, Park CK. Analysis of anatomical variations of bone and vascular structures around the posterior atlantal arch using three-dimensional computed tomography angiography. J Neurosurg Spine 2008;8:230–6.
• Akgun V, Battal B, Bozkurt Y, Oz O, Hamcan S, Sari S, Akgun H. Normal anatomical features and variations of the vertebrobasilar circulation and its branches: an analysis with 64‐detector row CT and 3T MR angiographies. Scientific World Journal 2013;29:620162.
• Tyler P, Datir A, Saifuddin A. Magnetic resonance imaging of anatomical variations in the knee. Skeletal Radiol 2010;39:1175–86.
• Farooq S, Jahan N, Arshad S. Anatomical variations of cystic artery during laparoscopic cholecystectomy; an audit of 400 cases of laparoscopic surgery for gall bladder pathologies at a tertiary care unit. Annals of Punjab Medical Journal 2019;13:72–7.
• Alraddadi A. Literature review of anatomical variations: clinical significance, identification approach, and teaching strategies. Cureus 2021;13:e14451.
• Ayre JR, Bazira PJ, Abumattar M, Makwana HN, Sanders KA. A new classification system for the anatomical variations of the human circle of Willis: a systematic review. J Anat 2022;240:1187–204.
• Varga I, Babala J, Kachlik D. Anatomic variations of the spleen: current state of terminology, classification, and embryological background. Surg Radiol Anat 2018;40:21–9.
• Chaib E, Kanas AF, Galvão FHF, D’Albuquerque LAC. Bile duct confluence: anatomic variations and its classification. Surg Radiol Anat 2014;36:105–9.
• Deka P, Islam M, Jindal D, Kumar N, Arora A, Negi SS. An analysis of biliary anatomy according to different classification systems. Indian J Gastroenterol 2014;33:23–30.
• Atoni AD, Oyinbo CA, Francis DAU, Tabowei UL. Anatomic variation of the sciatic nerve: a study on the prevalence, and bifurcation loci in relation to the piriformis and popliteal fossa. Acta Med Acad 2022;51:52–8.
• Barbosa ABM, Santos PV dos, Targino VA, Silva N de A, Silva YC de M, Gomes FB, Assis T de O. Sciatic nerve and its variations: is it possible to associate them with piriformis syndrome? Arq Neuropsiquiatr 2019;77:646–53.
• Wysiadecki G, Varga I, Klejbor I, Balawender K, Ghosh SK, Clarke E, Koziej M, Bonczar M, Ostrowski P, Żytkowski A. Reporting anatomical variations: Should unified standards and protocol (checklist) for anatomical studies and case reports be established? Translational Research in Anatomy 2024;35:100284.
• Svenonius S, Arms WY. The Intellectual Foundation of Information Organization. MIT press; 2000. [Internet]. [Retrieved on July 28, 2025]. Available from: https://mitpress.mit.edu/9780262512619/the-intellectual-foundation-of-information-organization/
• Ranganathan SR. Prolegomena to library Classification. Vol. 1–72. New York: Asia Publishing House - New York; 1967 [cited 2024 Oct 28]. [Internet]. [Retrieved on July 25, 2025]. Available from: https://repository.arizona.edu/handle/10150/106370
• Budhiraja V, Rastogi R, Asthana AK. Variations in the formation of median nerve and its clinical correlation. Folia Morphol (Warsz) 2012;71:28–30.
• Hegazy AMS. Anatomical study of the human ansa cervicalis nerve and its variations. International Journal of Anatomy and Physiology 2013;2:14–9.
• Anloague PA, Huijbregts P. Anatomical variations of the lumbar plexus: a descriptive anatomy study with proposed clinical implications. J Man Manip Ther 2009;17:e107–14.
• Guerri‐Guttenberg RA, Ingolotti M. Classifying musculocutaneous nerve variations. Clin Anat 2009;22:671–83.
• Hamabe A, Harino T, Ogino T, Tanida T, Noura S, Morita S, Dono K. Analysis of anatomical variations of intrapelvic vessels for advanced pelvic surgery. BMC Surg 2020;16:47.
• Toni R, Della Casa C, Mosca S, Malaguti A, Castorina S, Roti E. Anthropological variations in the anatomy of the human thyroid arteries. Thyroid 2003;13:183–92.
• Soares EWS. Anatomical variations of the axilla. Springerplus 2014;3:306.
• Ronald A. Bergman, Adel K. Afifi, Ryosuke Miyauchi. Illustrated encyclopedia of human anatomic variation [Internet]. [Retrieved on July 12, 2025]. Available from: https://www.anatomyatlases.org/AnatomicVariants/AnatomyHP.shtml
• Tomaszewski KA, Henry BM, Pękala PA, Standring S, Tubbs RS. The new frontier of studying human anatomy: introducing evidence‐based anatomy. Clin Anat 2018;31:4–5.
• Lowrance WW. The promise of human genetic databases. BMJ 2001;322:1009–10.
• Khan W, Kumar T, Zhang C, Raj K, Roy AM, Luo B. SQL and NoSQL database software architecture performance analysis and assessments – a systematic literature review. Big Data and Cognitive Computing 2023;7:97.
• Jayapala D, Mathangasinghe Y. The prevalence of termination variations of the basilar artery: a systematic review and meta-analysis. Proceedings of the International Federation of Associations of Anatomists (IFAA) Congress 2024;57:S267–8.
• Kachlik D, Varga I, Báča V, Musil V. Variant anatomy and its terminology. Medicina (Kaunas) 2020;56:713.